Healthcare Provider Details

I. General information

NPI: 1700984465
Provider Name (Legal Business Name): ZONNITA R BANKS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 6TH AVE STE 208
TROY NY
12180-3440
US

IV. Provider business mailing address

790 LANCASTER ST
ALBANY NY
12203-1541
US

V. Phone/Fax

Practice location:
  • Phone: 518-274-1164
  • Fax: 518-274-1379
Mailing address:
  • Phone: 518-489-4431
  • Fax: 518-489-5189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number046175
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: