Healthcare Provider Details

I. General information

NPI: 1003401647
Provider Name (Legal Business Name): JENNIFER M GARCIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7223 W CAVALIER DR
GLENDALE AZ
85303-4306
US

IV. Provider business mailing address

7223 W CAVALIER DR
GLENDALE AZ
85303-4306
US

V. Phone/Fax

Practice location:
  • Phone: 623-696-0739
  • Fax:
Mailing address:
  • Phone: 623-696-0739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-5353
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-18755
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: