Provider Demographics
NPI:1326795667
Name:GARCIA, KATHERINE (LAC, MAC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3282 S LENAVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:BENNETT
Mailing Address - State:CO
Mailing Address - Zip Code:80102-8541
Mailing Address - Country:US
Mailing Address - Phone:720-951-1005
Mailing Address - Fax:
Practice Address - Street 1:3282 S LENAVIEW CIR
Practice Address - Street 2:
Practice Address - City:BENNETT
Practice Address - State:CO
Practice Address - Zip Code:80102-8541
Practice Address - Country:US
Practice Address - Phone:720-951-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000519101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)