MEDICARE: ANDY HUMBERTO GARCIA LCSW

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	104100000X	Social Worker	090430	NY

General Provider Information

NPI Number	:	1184021313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDY HUMBERTO GARCIA LCSW

Provider Business Mailing Address
First Line	:	576 VALLEY RD # 132
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-3526
Country	:	US
Telephone Number	:	646-853-1120
Fax Number	:

Provider Business Practice Location Address
First Line	:	576 VALLEY RD # 132
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-3526
Country	:	US
Telephone Number	:	646-853-1120
Fax Number	:

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

Provider Enumeration Date	:	12/03/2014
Last Update Date	:	10/03/2025

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