Provider Demographics
NPI:1285196055
Name:HIGGINS, WENDY SUZETTE (LPC CSAC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:SUZETTE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LPC CSAC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:SUZETTE
Other - Last Name:BOLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSAC
Mailing Address - Street 1:205 E HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-1620
Mailing Address - Country:US
Mailing Address - Phone:540-965-2135
Mailing Address - Fax:540-965-6371
Practice Address - Street 1:311 S MONROE AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-1635
Practice Address - Country:US
Practice Address - Phone:540-965-2100
Practice Address - Fax:540-965-2105
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007818101YP2500X, 101Y00000X
VA0710102349101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)