Healthcare Provider Details

I. General information

NPI: 1508028424
Provider Name (Legal Business Name): KATHERINE GARCIA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 NE 1ST AVE
MIAMI FL
33132-1808
US

IV. Provider business mailing address

726 NE 1ST AVE
MIAMI FL
33132-1808
US

V. Phone/Fax

Practice location:
  • Phone: 305-374-1065
  • Fax: 305-371-4448
Mailing address:
  • Phone: 305-374-1065
  • Fax: 305-371-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 5663
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: