MEDICARE: MS. NICOLE 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	101YM0800X	Mental Health Counselor	005670	NY

General Provider Information

NPI Number	:	1952770406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE GARCIA LMHC

Provider Business Mailing Address
First Line	:	127 WASHINGTON ST
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2517
Country	:	US
Telephone Number	:	917-536-8065
Fax Number	:

Provider Business Practice Location Address
First Line	:	290 LENOX AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4991
Country	:	US
Telephone Number	:	917-536-8065
Fax Number	:

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

Provider Enumeration Date	:	09/15/2015
Last Update Date	:	12/19/2022

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