Provider Demographics
NPI:1891097820
Name:BANAS, CHRISTINE M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:M
Last Name:BANAS
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 1:446A BLAKE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1286
Mailing Address - Country:US
Mailing Address - Phone:203-387-9400
Mailing Address - Fax:888-772-2160
Practice Address - Street 1:446A BLAKE ST STE 200
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1286
Practice Address - Country:US
Practice Address - Phone:203-387-9400
Practice Address - Fax:888-772-2160
Is Sole Proprietor?:No
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0071951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical