Provider Demographics
NPI:1194493486
Name:GARCIA, REYNA AMANDA (LPCC, NCC)
Entity type:Individual
Prefix:
First Name:REYNA
Middle Name:AMANDA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67133
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87193-7133
Mailing Address - Country:US
Mailing Address - Phone:505-289-3984
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 67133
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87193-7133
Practice Address - Country:US
Practice Address - Phone:505-289-3984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0221141101YM0800X
NMT-CTL0215641101YM0800X
NMCTB-2024-0447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health