Provider Demographics
NPI:1386163343
Name:GARCIA, GRACE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
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 1:6719 BEACH CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1417
Mailing Address - Country:US
Mailing Address - Phone:631-213-1616
Mailing Address - Fax:631-919-0203
Practice Address - Street 1:6719 BEACH CHANNEL DR
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1417
Practice Address - Country:US
Practice Address - Phone:631-213-1616
Practice Address - Fax:631-919-0203
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110502104100000X
NY0980281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker