Provider Demographics
NPI:1801917323
Name:GARCIA, JUDITH ANN (RN, MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ANN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RN, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 CLAYTON RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1328
Mailing Address - Country:US
Mailing Address - Phone:314-647-3558
Mailing Address - Fax:314-647-3605
Practice Address - Street 1:7700 CLAYTON RD
Practice Address - Street 2:SUITE 208
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1328
Practice Address - Country:US
Practice Address - Phone:314-647-3558
Practice Address - Fax:314-647-3605
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0002761041C0700X, 106H00000X, 101YA0400X, 102L00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor