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General NPI Number Information
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NPI Number | 1326276312
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Entity Type | Individual
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Provider Name | LE ANDREA BANKS LCSWC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 3545 SAINT JOHNS BLUFF RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32224-2682
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Country | US
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Telephone | 301-801-4626
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Fax | 301-576-4554
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Provider Business Mailing Address
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Address Line | 3545 SAINT JOHNS BLUFF RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32224-2682
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Country | US
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Telephone | 301-801-4626
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW19148
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 007332
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14636
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License Number State | MD
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