MEDICARE: MR. ROBERT JOSEPH GARCIA MSW

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	1041C0700X	Clinical Social Worker	LICSW113956	MA
2	1041C0700X	Clinical Social Worker	LC4982	ME

General Provider Information

NPI Number	:	1013110907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT JOSEPH GARCIA MSW

Provider Business Mailing Address
First Line	:	1140 PLEASANT POINT RD
Second Line	:
City	:	CUSHING
State	:	ME
Zip	:	04563-3621
Country	:	US
Telephone Number	:	207-354-0619
Fax Number	:

Provider Business Practice Location Address
First Line	:	1140 PLEASANT POINT RD
Second Line	:
City	:	CUSHING
State	:	ME
Zip	:	04563-3621
Country	:	US
Telephone Number	:	207-354-0619
Fax Number	:

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	08/30/2010

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