Provider Demographics
NPI:1346810991
Name:GARCIA, CARLOS (LPC)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 CROSBY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-2415
Mailing Address - Country:US
Mailing Address - Phone:361-222-3687
Mailing Address - Fax:
Practice Address - Street 1:1304 CROSBY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TX
Practice Address - Zip Code:78374-2415
Practice Address - Country:US
Practice Address - Phone:361-222-3687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-27
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty