Provider Demographics
NPI:1538597448
Name:GARCIA, JADIG (PHD, LCP)
Entity type:Individual
Prefix:
First Name:JADIG
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PHD, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10571 TELEGRAPH RD STE 110
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-4652
Mailing Address - Country:US
Mailing Address - Phone:804-266-9616
Mailing Address - Fax:804-261-4935
Practice Address - Street 1:10571 TELEGRAPH RD STE 110
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-4652
Practice Address - Country:US
Practice Address - Phone:804-266-9616
Practice Address - Fax:804-261-4935
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent