Provider Demographics
NPI:1518552132
Name:GARCIA, JENNIFER (LMSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 WEST 124TH STREET
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 EAST 172ND STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460
Practice Address - Country:US
Practice Address - Phone:347-767-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111884104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker