MEDICARE: MARIA EDNA GARCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	5101	GA

General Provider Information

NPI Number	:	1003320490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA EDNA GARCIA

Provider Business Mailing Address
First Line	:	2440 SANDY PLAINS ROAD
Second Line	:	BUILDING 21 SUITE 200
City	:	MARIETTA
State	:	GA
Zip	:	30066-7233
Country	:	US
Telephone Number	:	404-579-2833
Fax Number	:	770-993-9800

Provider Business Practice Location Address
First Line	:	316 ALEXANDER ST SE STE 8
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-2001
Country	:	US
Telephone Number	:	404-579-2833
Fax Number	:	770-993-9800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2017
Last Update Date	:	12/12/2025

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