Provider Demographics
NPI:1164720652
Name:GARCIA, DANELYS
Entity Type:Individual
Prefix:
First Name:DANELYS
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 LARCHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2804
Mailing Address - Country:US
Mailing Address - Phone:914-575-1305
Mailing Address - Fax:914-560-2136
Practice Address - Street 1:131 LARCHMONT AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2804
Practice Address - Country:US
Practice Address - Phone:914-575-1305
Practice Address - Fax:914-560-2136
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007105-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health