Provider Demographics
NPI:1336991181
Name:BANKS, STEVEN A (LICSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:A
Last Name:BANKS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6114 BEDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1284
Mailing Address - Country:US
Mailing Address - Phone:802-490-4403
Mailing Address - Fax:
Practice Address - Street 1:6114 BEDSTONE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-1284
Practice Address - Country:US
Practice Address - Phone:802-490-4403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.01351631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical