Provider Demographics
NPI:1093331944
Name:BANANI, HALEH (LPC, LPA)
Entity Type:Individual
Prefix:
First Name:HALEH
Middle Name:
Last Name:BANANI
Suffix:
Gender:F
Credentials:LPC, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 W MCDERMOTT DR STE 150
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3088
Mailing Address - Country:US
Mailing Address - Phone:469-519-2777
Mailing Address - Fax:
Practice Address - Street 1:700 CENTRAL EXPY S STE 400
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8113
Practice Address - Country:US
Practice Address - Phone:469-342-3499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YM0800X, 101YP2500X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional