Provider Demographics
NPI:1760613020
Name:GARCIA PORTO, ANA VIRGINIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:VIRGINIA
Last Name:GARCIA PORTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:VIRGINIA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1301 5TH AVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3119
Mailing Address - Country:US
Mailing Address - Phone:212-426-3400
Mailing Address - Fax:212-410-7561
Practice Address - Street 1:1301 5TH AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3119
Practice Address - Country:US
Practice Address - Phone:212-426-3400
Practice Address - Fax:212-410-7561
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081723-11041C0700X
NY081149-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical