Provider Demographics
NPI:1437592128
Name:GARCIA, MARCOLINA (LADC)
Entity type:Individual
Prefix:MRS
First Name:MARCOLINA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:MRS
Other - First Name:MARCOLINA
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LADC
Mailing Address - Street 1:PO BOX 1674
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06144-1674
Mailing Address - Country:US
Mailing Address - Phone:860-893-0089
Mailing Address - Fax:860-893-0200
Practice Address - Street 1:1 GROVE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-4116
Practice Address - Country:US
Practice Address - Phone:860-893-0089
Practice Address - Fax:860-893-0200
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000952101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)