Individual provider Active NPI

Holly Higinbotham, PSYD

  • Clinical Psychologist
  • Pittsfield, MA
National Provider Identifier
1396850509
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7711 Issued in MA
Practice address
741 North St
Brien Family Center
Pittsfield, MA 01201-4109
Phone
(413) 447-2145
Fax
(413) 447-3245
NPI assigned
Aug 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7711 MA Primary

Addresses

Primary practice location

741 North St
Brien Family Center
Pittsfield, MA 01201-4109

Mailing address

1957 Old Route 9
Windsor, MA 01270-9399
Phone (413) 684-3724

Other identifiers 5

IdentifierTypeStateIssuer
31709OtherMAHEALTH NEW ENGLAND
472277OtherMATUFTS
1854330MedicaidMA
473816000OtherMAMAGELLAN
W06193OtherMABCBSMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050907000637 MA Practitioner - Clinical Psychologist 6507898830 Practice locations: Pittsfield, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

54 Wendell Ave
Suite 4
Pittsfield, MA 01201-6323
Phone (413) 443-1034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7711MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Berkshire Psychiatric Services,PC Past Accepting new patients
Lucian Radu MD PLLC PastSince May 10, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396850509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 OLD ROUTE 9",
            "city": "WINDSOR",
            "state": "MA",
            "postal_code": "012709399",
            "telephone_number": "413-684-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 NORTH ST",
            "address_2": "BRIEN FAMILY CENTER",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014109",
            "telephone_number": "413-447-2145",
            "fax_number": "413-447-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGINBOTHAM",
        "first_name": "HOLLY",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "31709",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "472277",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1854330",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "473816000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "W06193",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.