Healthcare Provider Details

I. General information

NPI: 1679063051
Provider Name (Legal Business Name): ANNE MARIE HIGGINS LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 05/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 OLD ORANGEBURG RD
ORANGEBURG NY
10962-1157
US

IV. Provider business mailing address

207 LONG CLOVE RD
NEW CITY NY
10956-6903
US

V. Phone/Fax

Practice location:
  • Phone: 845-406-7570
  • Fax: 845-680-5587
Mailing address:
  • Phone: 845-406-7570
  • Fax: 845-680-5587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number076189
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: