Provider Demographics
NPI:1326653494
Name:GARCIA, COLLEEN (LLPC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 LAKESHORE DR UNIT 114
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2639
Mailing Address - Country:US
Mailing Address - Phone:773-953-0358
Mailing Address - Fax:
Practice Address - Street 1:830 PLEASANT ST STE 201
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2279
Practice Address - Country:US
Practice Address - Phone:773-953-0358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health