Provider Demographics
NPI:1366147183
Name:HIGGINS, KELLY DARLENE
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:DARLENE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 QUAKER RD
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:VA
Mailing Address - Zip Code:23141-1900
Mailing Address - Country:US
Mailing Address - Phone:804-382-3972
Mailing Address - Fax:
Practice Address - Street 1:755 MARTIN LUTHER KING JR HWY
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807-1053
Practice Address - Country:US
Practice Address - Phone:540-568-1735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health