Provider Demographics
NPI:1376953273
Name:GARCIA, DYAN M (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:DYAN
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 VINSON RD S
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-4424
Mailing Address - Country:US
Mailing Address - Phone:325-829-3350
Mailing Address - Fax:
Practice Address - Street 1:490 VINSON RD S
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-4424
Practice Address - Country:US
Practice Address - Phone:325-829-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70970101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX70970OtherLPC CERTIFICATION NUMBER