Provider Demographics
NPI:1356185599
Name:BANISTER, WHITNEY RENAE (LMSW)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:RENAE
Last Name:BANISTER
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W GRAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HAYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67060-1286
Mailing Address - Country:US
Mailing Address - Phone:316-247-0249
Mailing Address - Fax:
Practice Address - Street 1:301 W GRAND AVE STE A
Practice Address - Street 2:
Practice Address - City:HAYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:67060-1286
Practice Address - Country:US
Practice Address - Phone:316-247-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13732104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty