Provider Demographics
NPI:1326444324
Name:GARCIA, KATHERINE G (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:G
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:G
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:4115 E VALLEY AUTO DR STE 208
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4612
Mailing Address - Country:US
Mailing Address - Phone:480-428-8998
Mailing Address - Fax:
Practice Address - Street 1:4115 E VALLEY AUTO DR STE 208
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4612
Practice Address - Country:US
Practice Address - Phone:480-428-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 102L00000X, 106H00000X
AZLPC16744101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist