Provider Demographics
NPI:1598404527
Name:GARCIA, KHRYSTAL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KHRYSTAL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 RIO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-3211
Mailing Address - Country:US
Mailing Address - Phone:254-205-9458
Mailing Address - Fax:
Practice Address - Street 1:6010 RIO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-3211
Practice Address - Country:US
Practice Address - Phone:254-205-9458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX650301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical