Provider Demographics
NPI:1134520877
Name:GARCIA, SETH ALLEN (LICDC-CS)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:ALLEN
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2552
Mailing Address - Country:US
Mailing Address - Phone:330-285-5100
Mailing Address - Fax:216-431-7189
Practice Address - Street 1:537 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2552
Practice Address - Country:US
Practice Address - Phone:330-285-5100
Practice Address - Fax:216-431-7189
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121157101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)