Provider Demographics
NPI:1326276312
Name:BANKS, LE ANDREA (LCSWC)
Entity Type:Individual
Prefix:MS
First Name:LE
Middle Name:ANDREA
Last Name:BANKS
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 ALEXANDER BELL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2105
Mailing Address - Country:US
Mailing Address - Phone:301-801-4626
Mailing Address - Fax:301-576-4554
Practice Address - Street 1:6700 ALEXANDER BELL DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2105
Practice Address - Country:US
Practice Address - Phone:301-801-4626
Practice Address - Fax:301-576-4554
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0073321041C0700X
MD146361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD023734500Medicaid
MDX2910001OtherCAREFIRST BCBS
MD648076OtherVALUEOPTIONS MEDICAID
MD28438775OtherCIGNA
MDX2910001OtherCAREFIRST BCBS
MD648076OtherVALUEOPTIONS MEDICAID
MD000444811OtherUNITED HEALTHCARE/UBH