Provider Demographics
NPI:1003569526
Name:GARCIA, YVONNE NATALIE (LPC)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:NATALIE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 N CENTRAL AVE APT 543
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1731
Mailing Address - Country:US
Mailing Address - Phone:623-308-0028
Mailing Address - Fax:
Practice Address - Street 1:2255 W NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4936
Practice Address - Country:US
Practice Address - Phone:602-242-1238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20558101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional