Provider Demographics
NPI:1265995047
Name:GARCIA, JAMIE LEE (LMSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LEE
Other - Last Name:DILLION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2010 SE COLFAX CT
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-6914
Mailing Address - Country:US
Mailing Address - Phone:517-745-8396
Mailing Address - Fax:
Practice Address - Street 1:2010 SE COLFAX CT
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-6914
Practice Address - Country:US
Practice Address - Phone:517-745-8396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010872271041C0700X
WI10199-231041C0700X
FLSW189891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical