Active NPI
Philip Charles Higgins, LICSW
- Clinical Social Worker
- Salem, MA
National Provider Identifier
1083890578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 114085
- Practice address
- 19 Front St
Ste 202
Salem, MA 01970-3795 - Phone
- (917) 626-5391
- NPI assigned
- Jan 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 114085 | MA | Primary |
Addresses
Primary practice location
19 Front St
Ste 202
Salem, MA 01970-3795
Mailing address
298A Highland Ave
Apt. 3
Somerville, MA 02144-3223
Phone (917) 626-5391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 2, 2024 through Apr 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114085 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458864000000",
"number": "1083890578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "298A HIGHLAND AVE",
"address_2": "APT. 3",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021443223",
"telephone_number": "917-626-5391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 FRONT ST",
"address_2": "STE 202",
"city": "SALEM",
"state": "MA",
"postal_code": "019703795",
"telephone_number": "917-626-5391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIGGINS",
"first_name": "PHILIP",
"middle_name": "CHARLES",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-14",
"last_updated": "2016-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "114085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.