Provider Demographics
NPI:1801416383
Name:HIGGINS, SARA DANIELLE (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:DANIELLE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5133 KASSON RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-8623
Mailing Address - Country:US
Mailing Address - Phone:518-810-4780
Mailing Address - Fax:
Practice Address - Street 1:5133 KASSON RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-8623
Practice Address - Country:US
Practice Address - Phone:518-810-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0890341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical