Provider Demographics
NPI:1992065957
Name:HIGDON, TERRY L (LMSW)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:L
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 1:14913 COOPER ORBIT RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-3903
Mailing Address - Country:US
Mailing Address - Phone:501-376-2747
Mailing Address - Fax:
Practice Address - Street 1:14913 COOPER ORBIT RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-3903
Practice Address - Country:US
Practice Address - Phone:501-376-2747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR197-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker