Basic Information
| Provider Information | |||||||||
| NPI: | 1801209416 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | TOMMY | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | LPMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 84 AMBER DR | ||||||||
| Address2: | |||||||||
| City: | CROTON ON HUDSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105201531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149438010 | ||||||||
| FaxNumber: | 9147884306 | ||||||||
| Practice Location | |||||||||
| Address1: | 84 AMBER DR | ||||||||
| Address2: | |||||||||
| City: | CROTON ON HUDSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105201531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149438010 | ||||||||
| FaxNumber: | 7185848394 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2014 | ||||||||
| LastUpdateDate: | 07/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | P92638 | NY | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | 00719101 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.