MEDICARE: KAREN BANKS M.ED., PLPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2013044101	MO

General Provider Information

NPI Number	:	1598182040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN BANKS M.ED., PLPC

Provider Business Mailing Address
First Line	:	PO BOX 32828
Second Line	:
City	:	OLIVETTE
State	:	MO
Zip	:	63132-8828
Country	:	US
Telephone Number	:	314-569-9990
Fax Number	:

Provider Business Practice Location Address
First Line	:	6365 CLAYTON RD
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63117-1808
Country	:	US
Telephone Number	:	314-569-9990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2014
Last Update Date	:	03/22/2014

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