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General NPI Number Information
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NPI Number | 1396185955
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Entity Type | Individual
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Provider Name | AMY MICHELLE HIGGINS L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 3910 OAKWOOD AVE
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City | LOS ANGELES
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State | CA
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Zip | 90004-3413
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Country | US
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Telephone | 323-953-7390
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Fax |
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Provider Business Mailing Address
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Address Line | 15339 SATICOY ST
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City | VAN NUYS
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State | CA
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Zip | 91406-3345
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Country | US
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Telephone | 562-833-9923
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ASW36169
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW72284
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License Number State | CA
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