Provider Demographics
NPI:1720264831
Name:GARCIA, VICTOR (MA, LPC)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 S XAVIER ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-2017
Mailing Address - Country:US
Mailing Address - Phone:303-922-6825
Mailing Address - Fax:
Practice Address - Street 1:4 W DRY CREEK CIR STE 200
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4458
Practice Address - Country:US
Practice Address - Phone:303-922-6825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012131101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12756376OtherCAQH