Provider Demographics
NPI:1447070982
Name:BANKS, AMBER (LMSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
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 1:92 SCHOLES ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-1891
Mailing Address - Country:US
Mailing Address - Phone:917-830-7290
Mailing Address - Fax:
Practice Address - Street 1:117 DOBBIN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-5502
Practice Address - Country:US
Practice Address - Phone:646-881-0305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122866-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker