Provider Demographics
NPI:1194342675
Name:GARCIA, JESSENIA ABIGAIL (LPC)
Entity type:Individual
Prefix:
First Name:JESSENIA
Middle Name:ABIGAIL
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 KATHRYN DR STE D
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4200
Mailing Address - Country:US
Mailing Address - Phone:800-972-0643
Mailing Address - Fax:214-279-5032
Practice Address - Street 1:105 KATHRYN DR STE D
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4200
Practice Address - Country:US
Practice Address - Phone:800-972-0643
Practice Address - Fax:214-279-5032
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78860101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty