Provider Demographics
NPI:1043981954
Name:GARCIA, JOSE DANIEL (LMSW,LCSW)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:DANIEL
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LMSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 W PROUTY ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-1703
Mailing Address - Country:US
Mailing Address - Phone:269-625-1761
Mailing Address - Fax:
Practice Address - Street 1:301 WILLIAMSTON CENTER RD STE 800
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:MI
Practice Address - Zip Code:48895-8502
Practice Address - Country:US
Practice Address - Phone:517-996-6097
Practice Address - Fax:517-996-6099
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010953261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical