MEDICARE: GARCIA COUNSELING

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	251S00000X	Community/Behavioral Health Agency	3904	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508132192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARCIA COUNSELING

Provider Business Mailing Address
First Line	:	7200 RUSTIC CREEK RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73165-7131
Country	:	US
Telephone Number	:	405-245-9520
Fax Number	:	405-793-8855

Provider Business Practice Location Address
First Line	:	7200 RUSTIC CREEK RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73165-7131
Country	:	US
Telephone Number	:	405-245-9520
Fax Number	:	405-793-8855

Authorized Official
Title or Position	:	CEO
Name	:	MRS. LEA A GARCIA
Credential	:	LPC
Telephone Number	:	405-245-9520

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	03/28/2012

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