Provider Demographics
NPI:1376756221
Name:GARCIA, DAVID G (LMSW, ACSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 EASTMAN AVE
Mailing Address - Street 2:SUITE 174
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6785
Mailing Address - Country:US
Mailing Address - Phone:989-450-1961
Mailing Address - Fax:898-892-4962
Practice Address - Street 1:5103 EASTMAN AVE
Practice Address - Street 2:SUITE 174
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6785
Practice Address - Country:US
Practice Address - Phone:989-450-1961
Practice Address - Fax:898-892-4962
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010661001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical