=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154086981
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HIGGINS COUNSELING & PSYCHOLOGICAL SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2021
-----------------------------------------------------
Last Update Date | 11/06/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1140 RAILROAD ST
-----------------------------------------------------
City | PASO ROBLES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93446-2532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-636-7244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1140 RAILROAD ST
-----------------------------------------------------
City | PASO ROBLES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93446-2532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-636-7244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT PSYCHOLOGIST
-----------------------------------------------------
Name | PATRICIA M HIGGINS
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 484-636-7244
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------