Provider Demographics
NPI:1225738016
Name:BANKS, HUNTER (LSW)
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:BANKS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 CLEARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08097-1448
Mailing Address - Country:US
Mailing Address - Phone:609-553-9890
Mailing Address - Fax:
Practice Address - Street 1:108 SOMERDALE RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1901
Practice Address - Country:US
Practice Address - Phone:856-633-0258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06677600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker