Provider Demographics
NPI:1154166395
Name:GARCIA, SAMUEL (LCSW, LCDC)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LCSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10807 FALL MILL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-1456
Mailing Address - Country:US
Mailing Address - Phone:713-542-4304
Mailing Address - Fax:
Practice Address - Street 1:4430 HARRISBURG
Practice Address - Street 2:SUITE 240
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011
Practice Address - Country:US
Practice Address - Phone:713-798-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51642104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker