Healthcare Provider Details

I. General information

NPI: 1407284649
Provider Name (Legal Business Name): JAMES BANKS JR. LGSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2013
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CLIFTON ST NW
WASHINGTON DC
20009-5217
US

IV. Provider business mailing address

5258 CHILLUM PL NE
WASHINGTON DC
20011-6418
US

V. Phone/Fax

Practice location:
  • Phone: 202-673-7385
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberLG50079097
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: