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General NPI Number Information
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NPI Number | 1508638669
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Entity Type | Organization
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Legal Business Name | LINDA BANNISTER COUNSELING, LLC
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 205 N COLLEGE AVE STE 311
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City | BLOOMINGTON
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State | IN
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Zip | 47404-3953
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Country | US
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Telephone | 317-902-8079
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 E BETHEL LN
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City | BLOOMINGTON
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State | IN
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Zip | 47408-9011
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Country | US
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Telephone | 317-902-8079
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDA L BANNISTER
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Credential | LMHC, ATR-BC
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Telephone | 317-902-8079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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