Provider Demographics
NPI:1992419469
Name:GARCIA, LINA M (LCPC)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7457 W FOREST PRESERVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-3311
Mailing Address - Country:US
Mailing Address - Phone:239-810-5570
Mailing Address - Fax:
Practice Address - Street 1:7457 W FOREST PRESERVE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-3311
Practice Address - Country:US
Practice Address - Phone:239-810-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180012731101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional