Provider Demographics
NPI:1083705057
Name:BANKERT, JOHN CRAIG (LMHC, CAP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CRAIG
Last Name:BANKERT
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NE 40TH CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1311
Mailing Address - Country:US
Mailing Address - Phone:954-703-3570
Mailing Address - Fax:954-709-3571
Practice Address - Street 1:201 NE 40TH CT
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-1311
Practice Address - Country:US
Practice Address - Phone:954-703-3570
Practice Address - Fax:954-709-3571
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH 8007OtherFL LICENSE