MEDICARE: MARIE YVETTE GARCIA LMSW

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	104100000X	Social Worker	M-0592	NM

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	:	1780112599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE YVETTE GARCIA LMSW

Provider Business Mailing Address
First Line	:	1001 GALLINAS ST
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-3826
Country	:	US
Telephone Number	:	505-454-8882
Fax Number	:	505-426-0190

Provider Business Practice Location Address
First Line	:	2020 7TH ST
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4958
Country	:	US
Telephone Number	:	505-587-1050
Fax Number	:	877-553-1272

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

Provider Enumeration Date	:	05/24/2017
Last Update Date	:	12/26/2024

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