Healthcare Provider Details

I. General information

NPI: 1508519679
Provider Name (Legal Business Name): SHANDA HIGGINS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2022
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 SCHOLAR WAY STE 101
SUMMERVILLE SC
29486-3052
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 843-501-1099
  • Fax: 843-405-2040
Mailing address:
  • Phone: 843-501-1099
  • Fax: 843-405-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9389
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7393
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: