Provider Demographics
NPI:1073989083
Name:GARCIA, JESSE (LCSW-S)
Entity Type:Individual
Prefix:MR
First Name:JESSE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LCSW-S
Other - Prefix:MR
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-S
Mailing Address - Street 1:6031 PINELAND DR APT 1211
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5451
Mailing Address - Country:US
Mailing Address - Phone:806-239-0674
Mailing Address - Fax:
Practice Address - Street 1:6031 PINELAND DR APT 1211
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5451
Practice Address - Country:US
Practice Address - Phone:806-239-0674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572691041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical