Provider Demographics
NPI:1720883978
Name:GARCIA, JUAN R (LMSW)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:R
Last Name:GARCIA
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CANFIELD AVE APT 821
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2054
Mailing Address - Country:US
Mailing Address - Phone:347-523-1484
Mailing Address - Fax:
Practice Address - Street 1:260 E 161ST ST FL 8
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-3512
Practice Address - Country:US
Practice Address - Phone:347-979-6712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123022104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker