Healthcare Provider Details

I. General information

NPI: 1982277539
Provider Name (Legal Business Name): JOEY JOHNATHON GARZA LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 JADWIN AVE
RICHLAND WA
99352-3434
US

IV. Provider business mailing address

1135 JADWIN AVE
RICHLAND WA
99352-3434
US

V. Phone/Fax

Practice location:
  • Phone: 509-942-3300
  • Fax: 509-946-1868
Mailing address:
  • Phone: 509-942-3300
  • Fax: 509-946-1868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.61662339
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: