Provider Demographics
NPI:1912132861
Name:GARCIA, SUSAN M (MA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:CROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-0040
Mailing Address - Country:US
Mailing Address - Phone:970-945-2241
Mailing Address - Fax:970-945-5523
Practice Address - Street 1:2128 RAILROAD AVE
Practice Address - Street 2:SUITE 005
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-3230
Practice Address - Country:US
Practice Address - Phone:970-625-3582
Practice Address - Fax:970-625-9707
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2206101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional