Provider Demographics
NPI:1770095937
Name:BANKS, ROSSILYN D (LMSW)
Entity type:Individual
Prefix:
First Name:ROSSILYN
Middle Name:D
Last Name:BANKS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 N SOMERSET ST APT 201
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-5747
Mailing Address - Country:US
Mailing Address - Phone:316-644-3865
Mailing Address - Fax:
Practice Address - Street 1:2305 N SOMERSET ST APT 201
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67204-5747
Practice Address - Country:US
Practice Address - Phone:316-644-3865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9883104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker