Provider Demographics
NPI:1013235498
Name:BANKS, AMANDA OWENS (LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:OWENS
Last Name:BANKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 AUGUSTA CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-1915
Mailing Address - Country:US
Mailing Address - Phone:864-877-7025
Mailing Address - Fax:
Practice Address - Street 1:4 PARKWAY COMMONS WAY
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-5213
Practice Address - Country:US
Practice Address - Phone:864-877-7025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional