Provider Demographics
NPI:1497277057
Name:GARCIA, JESSICA MAE (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MAE
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 1:751 HIGHWAY 287 N STE 103
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6604
Mailing Address - Country:US
Mailing Address - Phone:214-952-2324
Mailing Address - Fax:214-572-2986
Practice Address - Street 1:751 HIGHWAY 287 N STE 103
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6604
Practice Address - Country:US
Practice Address - Phone:214-952-2324
Practice Address - Fax:214-572-2986
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty