Healthcare Provider Details

I. General information

NPI: 1053645259
Provider Name (Legal Business Name): DAVID FREDERICK GARCIA LLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29550 FIVE MILE RD
LIVONIA MI
48154-3710
US

IV. Provider business mailing address

6549 TOWN CENTER DR
CLARKSTON MI
48346-4824
US

V. Phone/Fax

Practice location:
  • Phone: 800-395-3223
  • Fax: 248-620-6405
Mailing address:
  • Phone: 800-395-3223
  • Fax: 248-620-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6301014522
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6361002023
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: