Provider Demographics
NPI:1881864205
Name:GARCIA, GRECIA (LPC)
Entity type:Individual
Prefix:
First Name:GRECIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LPC
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 920336
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-0007
Mailing Address - Country:US
Mailing Address - Phone:915-491-3204
Mailing Address - Fax:
Practice Address - Street 1:6006 N MESA ST
Practice Address - Street 2:SUITE 408
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4659
Practice Address - Country:US
Practice Address - Phone:915-491-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62131101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9075LCOtherBLUE CROSS BLUE SHIELD OF TEXAS
TX1907685-01Medicaid