Provider Demographics
NPI:1235685215
Name:GARCIA RIVERA, DESIREE MARIE (LMHC-QS, NCC)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:MARIE
Last Name:GARCIA RIVERA
Suffix:
Gender:F
Credentials:LMHC-QS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5449 S SEMORAN BLVD STE 20
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-1778
Mailing Address - Country:US
Mailing Address - Phone:407-734-1273
Mailing Address - Fax:
Practice Address - Street 1:5449 S SEMORAN BLVD STE 20
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1778
Practice Address - Country:US
Practice Address - Phone:407-734-1273
Practice Address - Fax:866-738-7531
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17894101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty