Provider Demographics
NPI:1578705927
Name:GARCIA, CARMEN ELENA (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:ELENA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11909 ANDREW ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1149
Mailing Address - Country:US
Mailing Address - Phone:301-503-3045
Mailing Address - Fax:
Practice Address - Street 1:2446 REEDIE DR STE 1
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-4651
Practice Address - Country:US
Practice Address - Phone:301-503-3045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2847101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional