Provider Demographics
NPI:1861139834
Name:HIGGINS, ANDREA SUZANNE (LCPC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:SUZANNE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-0520
Mailing Address - Country:US
Mailing Address - Phone:713-320-4349
Mailing Address - Fax:
Practice Address - Street 1:4477 W EMERALD ST STE C225
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-2076
Practice Address - Country:US
Practice Address - Phone:713-320-4349
Practice Address - Fax:208-318-0218
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional