Provider Demographics
NPI:1295349124
Name:GARCIA, JOANNE (CACAC-T)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CACAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 HEGEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-7017
Mailing Address - Country:US
Mailing Address - Phone:616-953-5594
Mailing Address - Fax:
Practice Address - Street 1:545 HEGEMAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-7017
Practice Address - Country:US
Practice Address - Phone:616-953-5594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)