Provider Demographics
NPI:1952511909
Name:BANKS, KAREN J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:J
Last Name:BANKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:J
Other - Last Name:GREENE-BANKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:11352 AMBOY LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6103
Mailing Address - Country:US
Mailing Address - Phone:314-355-0613
Mailing Address - Fax:
Practice Address - Street 1:11352 AMBOY LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6103
Practice Address - Country:US
Practice Address - Phone:314-355-0613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002842104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical