Provider Demographics
NPI:1992196281
Name:BANKS CENTER FOR INSIGHT, COUNSELING AND HEALTH RESOURCES
Entity Type:Organization
Organization Name:BANKS CENTER FOR INSIGHT, COUNSELING AND HEALTH RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPY
Authorized Official - Prefix:
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:CAROLYN
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:313-305-4008
Mailing Address - Street 1:2328 E 7 MILE RD
Mailing Address - Street 2:STE. 4
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1304
Mailing Address - Country:US
Mailing Address - Phone:313-305-4008
Mailing Address - Fax:313-305-4972
Practice Address - Street 1:2328 E 7 MILE RD
Practice Address - Street 2:STE. 4
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1304
Practice Address - Country:US
Practice Address - Phone:313-305-4008
Practice Address - Fax:313-305-4972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801094417261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)