Provider Demographics
NPI:1003202656
Name:BANKSON, AMBER (LMHC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BANKSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 E 28TH ST
Mailing Address - Street 2:SUITE 408
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7919
Mailing Address - Country:US
Mailing Address - Phone:347-291-6721
Mailing Address - Fax:
Practice Address - Street 1:37 E 28TH ST
Practice Address - Street 2:SUITE 408
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7919
Practice Address - Country:US
Practice Address - Phone:347-291-6721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-10
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health