Provider Demographics
NPI:1922379429
Name:BANKS, LAURA RIFKIN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:RIFKIN
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 1:8127 MESA DR # B206-360
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8774
Mailing Address - Country:US
Mailing Address - Phone:402-850-1775
Mailing Address - Fax:
Practice Address - Street 1:4807 SPICEWOOD SPRINGS RD STE 1140
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8479
Practice Address - Country:US
Practice Address - Phone:402-850-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-16
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX511361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical