Provider Demographics
NPI:1457636631
Name:GARCIA, ERCILIA A (LHMC)
Entity Type:Individual
Prefix:
First Name:ERCILIA
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 AUDUBON AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4237
Mailing Address - Country:US
Mailing Address - Phone:212-837-2786
Mailing Address - Fax:212-837-2787
Practice Address - Street 1:311 AUDUBON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4237
Practice Address - Country:US
Practice Address - Phone:212-837-2786
Practice Address - Fax:212-837-2787
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002754101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002754OtherLICENSE