Provider Demographics
NPI:1437873627
Name:GARCIA, MARIAH (LMSW)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:
Other - Last Name:JOHNS GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:2950 E MAGIC VIEW DR STE 192
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-6246
Mailing Address - Country:US
Mailing Address - Phone:208-600-2184
Mailing Address - Fax:
Practice Address - Street 1:2950 E MAGIC VIEW DR STE 192
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-6246
Practice Address - Country:US
Practice Address - Phone:208-600-2184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID42721104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker