Provider Demographics
NPI:1104587815
Name:SAMANTHA GARCIA PLLC
Entity type:Organization
Organization Name:SAMANTHA GARCIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-252-0518
Mailing Address - Street 1:2785 GARFIELD RD N STE C
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-5168
Mailing Address - Country:US
Mailing Address - Phone:231-252-0518
Mailing Address - Fax:231-943-2555
Practice Address - Street 1:2785 GARFIELD RD N STE C
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5168
Practice Address - Country:US
Practice Address - Phone:231-252-0518
Practice Address - Fax:231-943-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty