MEDICARE: KATHERINE G GARCIA LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	102L00000X	Psychoanalyst
4	106H00000X	Marriage & Family Therapist
5	101YP2500X	Professional Counselor	LPC16744	AZ

General Provider Information

NPI Number	:	1326444324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE G GARCIA LPC

Provider Business Mailing Address
First Line	:	4115 E VALLEY AUTO DR STE 208
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4612
Country	:	US
Telephone Number	:	480-428-8998
Fax Number	:

Provider Business Practice Location Address
First Line	:	4115 E VALLEY AUTO DR STE 208
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4612
Country	:	US
Telephone Number	:	480-428-8998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2014
Last Update Date	:	12/11/2024

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