Individual provider Active NPI

Christopher Mark Higdon, LCSW

  • Clinical Social Worker
  • Herrin, IL
National Provider Identifier
1497449771
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149026876 Issued in IL
Practice address
101 Chittyville Rd
Herrin, IL 62948-3552
Phone
(618) 498-0190
NPI assigned
Jun 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149026876 IL Primary

Addresses

Primary practice location

101 Chittyville Rd
Herrin, IL 62948-3552

Mailing address

101 Chittyville Rd
Herrin, IL 62948-3552
Phone (618) 498-0190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • 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
I20240514000144 IL Practitioner - Clinical Social Worker 5799126330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149026876ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health of Southern Illinois, LTD. CurrentSince Apr 12, 2024 Accepting new patients
Koen Counseling and Wellness Center CurrentSince Apr 27, 2025 Accepting new patients
Integrated Health of Southern Illinois CurrentSince Apr 12, 2024 Accepting new patients

Locations

310 W Plaza Dr
Carterville, IL 62918
Phone (618) 525-0719

308 W Plaza Dr
Ste A
Carterville, IL 62918
Phone (618) 985-4344

303 S Commercial St
Ste 10
Harrisburg, IL 62946
Phone (618) 252-5555

101 Chittyville Rd
Herrin, IL 62948
Phone (618) 498-0190

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26231/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1497449771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CHITTYVILLE RD",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483552",
            "telephone_number": "618-498-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHITTYVILLE RD",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483552",
            "telephone_number": "618-498-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGDON",
        "first_name": "CHRISTOPHER",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149026876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.