Crystal Nicole Garcia, LMHC, LCACA, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39004337A Issued in IN

Practice address

3503 Martin Luther King Dr
Gary, IN 46409-1233

Phone

(219) 880-1190

NPI assigned

Mar 8, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Porter-Starke Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valparaiso, IN
  • NPI 1689627598
  Medicare reassignment NPD
• Porter-Starke Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1659196236
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1639879570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12334 PERRY ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077229",
            "telephone_number": "219-775-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3503 MARTIN LUTHER KING DR",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464091233",
            "telephone_number": "219-880-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "CRYSTAL",
        "middle_name": "NICOLE",
        "credential": "LMHC, LCACA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87900042A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004337A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaela Funches, FNP
• Pamela Gabor
• Joshlyn M Gaines, CNA
• Andrea Shantal Galloway
• Cynthia Galvan, M.D.
• Marie Garcia, RPT
• Naelah Gardner, PMHNP
• Timothy F Gardner, NP
• Gary City Working and Procedure Clinic LLC-S
• Gary Community Schools Corportion

• Mental Health Counselor in Gary, IN
• Providers in Gary, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.