Provider Demographics
NPI:1457996381
Name:BANKSTON, ERICA M (LISW-S)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:M
Last Name:BANKSTON
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7185 E MAIN ST UNIT 333
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2074
Mailing Address - Country:US
Mailing Address - Phone:614-367-5191
Mailing Address - Fax:614-522-3128
Practice Address - Street 1:7185 E MAIN ST UNIT 333
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2074
Practice Address - Country:US
Practice Address - Phone:614-367-5191
Practice Address - Fax:614-522-3128
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2023-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical