Provider Demographics
NPI:1235796426
Name:GARCIA, ANTHONY (LMHC, CAP)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12381 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3893
Mailing Address - Country:US
Mailing Address - Phone:239-203-8807
Mailing Address - Fax:
Practice Address - Street 1:12381 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3893
Practice Address - Country:US
Practice Address - Phone:239-203-8807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLADC-008187-2015101YA0400X
FLMH15682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLADC-008187-2015OtherFLORIDA CERTIFICATION BOARD
FLMH15682OtherFLORIDA DEPARTMENT OF HEALTH