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General NPI Number Information
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NPI Number | 1578233664
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Entity Type | Individual
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Provider Name | LAKEISHA TENICE BANKS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 284 EXECUTIVE PARK DR STE 100
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City | CONCORD
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State | NC
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Zip | 28025-1833
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Country | US
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Telephone | 704-939-1100
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Fax | 704-939-1173
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Provider Business Mailing Address
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Address Line | 195 CLUSTERS CIR
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City | MOORESVILLE
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State | NC
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Zip | 28117-8127
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Country | US
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Telephone | 331-330-0238
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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 | 17379
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License Number State | SC
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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 | C017697
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License Number State | NC
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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 | 149027690
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License Number State | IL
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