Healthcare Provider Details

I. General information

NPI: 1740888247
Provider Name (Legal Business Name): PATRICIA GARCIA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-1102
US

IV. Provider business mailing address

1321 15TH ST SE
RIO RANCHO NM
87124-3504
US

V. Phone/Fax

Practice location:
  • Phone: 505-999-0316
  • Fax: 505-944-1939
Mailing address:
  • Phone: 505-900-4295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB20240524
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: