Provider Demographics
NPI:1700417086
Name:GARCIA, JORGE (BCBA)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 LEDGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-1024
Mailing Address - Country:US
Mailing Address - Phone:913-219-8413
Mailing Address - Fax:
Practice Address - Street 1:370 OSGOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-2700
Practice Address - Country:US
Practice Address - Phone:860-832-6285
Practice Address - Fax:860-612-6389
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT42103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst