Provider Demographics
NPI:1386163343
Name:GARCIA, GRACE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:611 ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-7217
Mailing Address - Country:US
Mailing Address - Phone:718-213-0324
Mailing Address - Fax:
Practice Address - Street 1:611 ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-7217
Practice Address - Country:US
Practice Address - Phone:718-213-0324
Practice Address - Fax:718-213-0324
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0980281041C0700X
NY110502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker