Provider Demographics
NPI:1720305360
Name:GARCIA, ISABEL C (MPH, LCAT)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:C
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MPH, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 BOND ST APT C401
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-5189
Mailing Address - Country:US
Mailing Address - Phone:786-252-8074
Mailing Address - Fax:646-568-7604
Practice Address - Street 1:177 PRINCE ST APT 505
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012
Practice Address - Country:US
Practice Address - Phone:786-252-8074
Practice Address - Fax:646-568-7604
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY001476101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001476OtherLICENSE NUMBER (LCAT)
NY133303089Medicaid