Provider Demographics
NPI:1629760772
Name:VIR-BANKS, SALMA JOSEPHINE (LMHC)
Entity Type:Individual
Prefix:
First Name:SALMA
Middle Name:JOSEPHINE
Last Name:VIR-BANKS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 PASEO DEL PUEBLO NORTE UNIT 1453
Mailing Address - Street 2:
Mailing Address - City:EL PRADO
Mailing Address - State:NM
Mailing Address - Zip Code:87529-8062
Mailing Address - Country:US
Mailing Address - Phone:323-537-1996
Mailing Address - Fax:
Practice Address - Street 1:7510 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1500
Practice Address - Country:US
Practice Address - Phone:323-537-1996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2023-0404101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health