Provider Demographics
NPI:1558054361
Name:GARCIA, AMANDA J (LMSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
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 1:205 LAKOTA CT
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-3755
Mailing Address - Country:US
Mailing Address - Phone:210-535-7332
Mailing Address - Fax:
Practice Address - Street 1:205 LAKOTA CT
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-3755
Practice Address - Country:US
Practice Address - Phone:210-535-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67574104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker