Provider Demographics
NPI:1235248923
Name:BANNER, DAVID C (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:BANNER
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 DORSEY CIR STE 201
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-8303
Mailing Address - Country:US
Mailing Address - Phone:703-330-5155
Mailing Address - Fax:703-330-5925
Practice Address - Street 1:8401 DORSEY CIR STE 201
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-8303
Practice Address - Country:US
Practice Address - Phone:703-330-5155
Practice Address - Fax:703-330-5925
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001693101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health