Provider Demographics
NPI:1578915864
Name:ANEAS GARCIA, SOFIA (LMHC BCBA)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:ANEAS GARCIA
Suffix:
Gender:F
Credentials:LMHC BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 NE 106TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2037
Mailing Address - Country:US
Mailing Address - Phone:786-238-2008
Mailing Address - Fax:
Practice Address - Street 1:186 NE 106TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2037
Practice Address - Country:US
Practice Address - Phone:786-238-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-18-34314103K00000X
FLLMHC 14172101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018046600Medicaid