Provider Demographics
NPI:1083265912
Name:GARCIA, DANIEL RICHARD (LPC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:RICHARD
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 MCARDLE DR STE G
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-8149
Mailing Address - Country:US
Mailing Address - Phone:815-526-0676
Mailing Address - Fax:
Practice Address - Street 1:760 MCARDLE DR STE G
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8149
Practice Address - Country:US
Practice Address - Phone:815-526-0676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL170.017252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health