Provider Demographics
NPI:1619128295
Name:GARCIA, MARICELA (LMSW)
Entity Type:Individual
Prefix:
First Name:MARICELA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MARICELA
Other - Middle Name:
Other - Last Name:GALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1630 WELLS BRANCH PKWY APT 817
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-7160
Mailing Address - Country:US
Mailing Address - Phone:210-385-0434
Mailing Address - Fax:
Practice Address - Street 1:1630 WELLS BRANCH PKWY APT 817
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-7160
Practice Address - Country:US
Practice Address - Phone:210-385-0434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39984104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker