Individual provider Active NPI

Jeffrey Quidore Higginson, L.I.C.D.C.

  • Addiction (Substance Use Disorder) Counselor
  • Wooster, OH
National Provider Identifier
1740452390
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
923393 Issued in OH
Practice address
104 Spink St
3Rd Floor
Wooster, OH 44691-3652
Phone
(330) 264-8498
Fax
(330) 264-3777
NPI assigned
Mar 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 923393 OH Primary

Addresses

Primary practice location

104 Spink St
3Rd Floor
Wooster, OH 44691-3652

Mailing address

104 Spink St
3Rd Floor
Wooster, OH 44691-3652
Phone (330) 264-8498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
923393OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1740452390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "address_2": "3RD FLOOR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498",
            "fax_number": "330-264-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "address_2": "3RD FLOOR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498",
            "fax_number": "330-264-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINSON",
        "first_name": "JEFFREY",
        "middle_name": "QUIDORE",
        "name_prefix": "Mr.",
        "credential": "L.I.C.D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "923393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.