Healthcare Provider Details

I. General information

NPI: 1346706298
Provider Name (Legal Business Name): CYNTHIA EVELYN GARCIA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 S SOLANO DR
LAS CRUCES NM
88001-3781
US

IV. Provider business mailing address

1320 S SOLANO DR
LAS CRUCES NM
88001-3781
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-4004
  • Fax:
Mailing address:
  • Phone: 575-522-4004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2022-0642
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCMH0201971
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: