Provider Demographics
NPI:1174034383
Name:GARCIA, ALISHA GENEVA (LPC)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:GENEVA
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 1:3440 GLENMONT DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-3135
Mailing Address - Country:US
Mailing Address - Phone:682-215-6546
Mailing Address - Fax:
Practice Address - Street 1:2415 COIT RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3758
Practice Address - Country:US
Practice Address - Phone:972-596-7229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-14
Last Update Date:2017-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73183101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor