Provider Demographics
NPI:1881320695
Name:GARCIA, EDWARD (MRC/MPSY)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MRC/MPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6904
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6904
Mailing Address - Country:US
Mailing Address - Phone:787-989-2424
Mailing Address - Fax:
Practice Address - Street 1:CARR.181 KM 47.1, BARRIO CELADA
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-0072
Practice Address - Country:US
Practice Address - Phone:787-989-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1094101Y00000X
PR6645103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1094OtherCOUNSELOR
PR6645OtherPSICLOGO