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1023022837

NPI Code Detail

MEDICARE: MS. AMY LYNN HIGDON LPC

MEDICARE: MS. AMY LYNN HIGDON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	3266	LA
2	101YP2500X	Professional Counselor	P0905031	AR
3	101YP2500X	Professional Counselor	66594	TX
4	101Y00000X	Counselor	A0401004	AR
5	101YM0800X	Mental Health Counselor	66594	TX

General Provider Information

NPI Number	:	1023022837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY LYNN HIGDON LPC

Provider Business Mailing Address
First Line	:	540 OAK CENTRE DR STE 205
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4767
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 OAK CENTRE DR STE 205
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4767
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	05/13/2024

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Directions to “ MS. AMY LYNN HIGDON LPC” Practice Location

Language	Start Address	Practice Location

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