Provider Demographics
NPI:1447672316
Name:HIGGERSON, KRISTIN (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HIGGERSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5107 MAPLEGROVE CT
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3142
Mailing Address - Country:US
Mailing Address - Phone:989-280-3403
Mailing Address - Fax:
Practice Address - Street 1:5107 MAPLEGROVE CT
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3142
Practice Address - Country:US
Practice Address - Phone:989-280-3403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010996091041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical