Provider Demographics
NPI:1437436144
Name:GARCIA, MARISOL (LPC)
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 MEADOW RD
Mailing Address - Street 2:SUITE 134
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3769
Mailing Address - Country:US
Mailing Address - Phone:214-960-2427
Mailing Address - Fax:
Practice Address - Street 1:8340 MEADOW RD
Practice Address - Street 2:SUITE 134
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3769
Practice Address - Country:US
Practice Address - Phone:214-960-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65670101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional