Provider Demographics
NPI:1457443426
Name:GARCIA, LORRAINE G (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:G
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:LORRAINE
Other - Middle Name:G
Other - Last Name:KIRK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:531 S KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3819
Mailing Address - Country:US
Mailing Address - Phone:443-676-0895
Mailing Address - Fax:
Practice Address - Street 1:1414 KEY HWY STE P300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5189
Practice Address - Country:US
Practice Address - Phone:443-676-0895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1973101YM0800X
LC1973101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
54744401OtherCAREFIRST IMP
R5830052OtherCAREFIRST IGHMSI
261136OtherCOMPSYCH
MD408951100Medicaid