Provider Demographics
NPI:1417182841
Name:GARCIA, SYLVIA (MA, LISAC)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MA, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 N HIBBERT
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-7421
Mailing Address - Country:US
Mailing Address - Phone:602-291-5210
Mailing Address - Fax:480-461-6816
Practice Address - Street 1:37 N HIBBERT
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-7421
Practice Address - Country:US
Practice Address - Phone:602-291-5210
Practice Address - Fax:480-461-6816
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AZLISAC 10024101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health