Individual
DERRICK LAVON HIGHTOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCI
Contact information
Practice address
710 S CHURCH ST, SPARTANBURG, SC 29306-5345
(864) 230-6479
(864) 578-7176
Mailing address
113 BITTERNUT LN, TAYLORS, SC 29687-5865
(864) 230-6479
(864) 578-7176
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4714
SC
101YM0800X
Mental Health Counselor
4714
SC
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
4714
SC
Other
Enumeration date
07/02/2006
Last updated
02/06/2012
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