Provider Demographics
NPI:1154059012
Name:GARZA, MARISOL (LMSW)
Entity type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:GARZA
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2312
Mailing Address - Country:US
Mailing Address - Phone:361-462-4159
Mailing Address - Fax:361-462-4153
Practice Address - Street 1:1126 3RD ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2312
Practice Address - Country:US
Practice Address - Phone:361-462-4159
Practice Address - Fax:361-462-4153
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113475104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker