Healthcare Provider Details

I. General information

NPI: 1205761517
Provider Name (Legal Business Name): AMY GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 TERRACE POINT DR STE 375
MUSKEGON MI
49440-1149
US

IV. Provider business mailing address

862 W MOUNT GARFIELD RD
NORTON SHORES MI
49441-6132
US

V. Phone/Fax

Practice location:
  • Phone: 616-439-1866
  • Fax:
Mailing address:
  • Phone: 616-439-1866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451025112
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: