Provider Demographics
NPI:1235482423
Name:GARCIA, JAZMIN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JAZMIN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MISOCIALWORKER, LLC
Other - Middle Name:
Other - Last Name:MISOCIALWORKER, LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:16693 BELL CREEK LN
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-2936
Mailing Address - Country:US
Mailing Address - Phone:313-364-0110
Mailing Address - Fax:
Practice Address - Street 1:14355 BRADY
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3318
Practice Address - Country:US
Practice Address - Phone:313-364-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2025-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010931941041C0700X
1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN99590024OtherINDIVIDUAL MEDICARE PTAN