Healthcare Provider Details

I. General information

NPI: 1134046097
Provider Name (Legal Business Name): JULIE M BANKS LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 LAFAYETTE ST
NORWICH CT
06360-2708
US

IV. Provider business mailing address

310 BOSTON POST RD UNIT 84
WATERFORD CT
06385-1972
US

V. Phone/Fax

Practice location:
  • Phone: 860-934-3639
  • Fax:
Mailing address:
  • Phone: 860-934-3639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9706
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: