Provider Demographics
NPI:1740937721
Name:LARIOS GARCIA, VINICIO (MA)
Entity type:Individual
Prefix:
First Name:VINICIO
Middle Name:
Last Name:LARIOS GARCIA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:VINICIO
Other - Middle Name:
Other - Last Name:LARIOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1850 OAK ST
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3042
Mailing Address - Country:US
Mailing Address - Phone:847-441-5600
Mailing Address - Fax:
Practice Address - Street 1:1850 OAK ST
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3042
Practice Address - Country:US
Practice Address - Phone:847-441-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health