Provider Demographics
NPI:1124188461
Name:BANKS, LUCY I
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:I
Last Name:BANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 FEATHERSTAR LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-3305
Mailing Address - Country:US
Mailing Address - Phone:832-338-6855
Mailing Address - Fax:281-580-4369
Practice Address - Street 1:11315 FEATHERSTAR LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-3305
Practice Address - Country:US
Practice Address - Phone:832-338-6855
Practice Address - Fax:281-580-4369
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08035201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health