Provider Demographics
NPI:1669468252
Name:BANKS, GAIL A (LCSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:A
Last Name:BANKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 E BESSEMER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6324
Mailing Address - Country:US
Mailing Address - Phone:336-379-7144
Mailing Address - Fax:336-379-7145
Practice Address - Street 1:213 E BESSEMER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6324
Practice Address - Country:US
Practice Address - Phone:336-379-7144
Practice Address - Fax:336-379-7145
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0016881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACO4131Medicare ID - Type UnspecifiedEMPLOYER'S GROUP NUMBER
VA008776P31Medicare ID - Type UnspecifiedINDIVIDAL NUMBER
VA004945221Medicare ID - Type UnspecifiedGROUP NUMBER