Provider Demographics
NPI:1790820371
Name:BANKS, MICHELLE RAPP (LPC, LMFT, NCC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RAPP
Last Name:BANKS
Suffix:
Gender:F
Credentials:LPC, LMFT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12529 COURSEY BLVD
Mailing Address - Street 2:#1086
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4573
Mailing Address - Country:US
Mailing Address - Phone:504-813-4796
Mailing Address - Fax:225-771-8088
Practice Address - Street 1:12529 COURSEY BLVD
Practice Address - Street 2:#1086
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4573
Practice Address - Country:US
Practice Address - Phone:504-813-4796
Practice Address - Fax:225-771-8088
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional