Healthcare Provider Details

I. General information

NPI: 1700011442
Provider Name (Legal Business Name): ALISON GARCIA M.S., LMHC. CCTP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 TIMBERLACHEN CIR
LAKE MARY FL
32746-6124
US

IV. Provider business mailing address

PO BOX 950441
LAKE MARY FL
32795-0441
US

V. Phone/Fax

Practice location:
  • Phone: 321-262-3442
  • Fax:
Mailing address:
  • Phone: 321-262-3442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMH11164
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH11164
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH11164
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberMH11164
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: