MEDICARE: LISA GARCIA LMHC

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	390200000X	Student in an Organized Health Care Education/Training Program
2	101YM0800X	Mental Health Counselor	9587	MA

General Provider Information

NPI Number	:	1346521051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA GARCIA LMHC

Provider Business Mailing Address
First Line	:	95 BERKELEY ST
Second Line	:	SUITE 600
City	:	BOSTON
State	:	MA
Zip	:	02116-6230
Country	:	US
Telephone Number	:	617-350-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	399 BOYLSTON ST # 900B
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02116-3305
Country	:	US
Telephone Number	:	857-259-4021
Fax Number	:

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

Provider Enumeration Date	:	09/08/2011
Last Update Date	:	03/14/2019

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