Provider Demographics
NPI:1982946794
Name:GARCIA, LISA RENEE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:RENEE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2202
Mailing Address - Country:US
Mailing Address - Phone:301-570-7500
Mailing Address - Fax:301-570-7504
Practice Address - Street 1:3430 N HIGH ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-2202
Practice Address - Country:US
Practice Address - Phone:301-570-7500
Practice Address - Fax:301-570-7504
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical