Individual
MR. LESTER LESLIE HIGGENBOTTOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LPC, CADCIII
Contact information
Practice address
1820 ARLINGTON AVE, RACINE, WI 53403
(262) 637-9933
(262) 637-9933
Mailing address
1820 ARLINGTON AVE, RACINE, WI 53403
(262) 637-9933
(262) 637-9933
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
793
WI
101YP2500X
Professional Counselor
1012-125
WI
104100000X
Social Worker
Primary
2031-123
WI
1041C0700X
Clinical Social Worker
2031-123
WI
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39227800
—
WI
Enumeration date
10/04/2006
Last updated
07/10/2023
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