Provider Demographics
NPI:1790908911
Name:BANKS, LUCY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:
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 1:3913 OLD LEE HWY
Mailing Address - Street 2:SUITE 32A
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2433
Mailing Address - Country:US
Mailing Address - Phone:703-352-9009
Mailing Address - Fax:703-352-8999
Practice Address - Street 1:3913 OLD LEE HWY
Practice Address - Street 2:SUITE 32A
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2433
Practice Address - Country:US
Practice Address - Phone:703-352-9009
Practice Address - Fax:703-352-8999
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040007651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical