Individual provider Active NPI

Julienne Higginbottom, LCSW ACSW

  • Clinical Social Worker
  • Fayetteville, AR
National Provider Identifier
1861959066
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6662-C Issued in AR
Practice address
1 W Mountain St Ste 309
Fayetteville, AR 72701-6068
Phone
(479) 385-7775
NPI assigned
Feb 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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 6662-C AR Primary

Addresses

Primary practice location

1 W Mountain St Ste 309
Fayetteville, AR 72701-6068

Mailing address

1 W Mountain St Ste 309
Fayetteville, AR 72701-6068
Phone (501) 276-8022

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
6662-CARMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1550880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1861959066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W MOUNTAIN ST STE 309",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016068",
            "telephone_number": "501-276-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W MOUNTAIN ST STE 309",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016068",
            "telephone_number": "479-385-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTTOM",
        "first_name": "JULIENNE",
        "credential": "LCSW ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-23",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6662-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.