Provider Demographics
NPI:1427531987
Name:HIGDON, DAVID (LMSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HIGDON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 AURORA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50322-2833
Mailing Address - Country:US
Mailing Address - Phone:515-883-1776
Mailing Address - Fax:515-883-2171
Practice Address - Street 1:6000 AURORA
Practice Address - Street 2:SUITE B
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50322-5032
Practice Address - Country:US
Practice Address - Phone:515-883-1776
Practice Address - Fax:515-883-2171
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03654101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health