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NPI Code Detail

MEDICARE: STEVE BANBURY LCSW

MEDICARE: STEVE BANBURY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker071795NY

General Provider Information

NPI Number : 1093963597
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVE BANBURY LCSW
Provider Business Mailing Address
First Line : 60 ACADEMY RD
Second Line :
City : ALBANY
State : NY
Zip : 12208-3103
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 60 ACADEMY RD
Second Line :
City : ALBANY
State : NY
Zip : 12208-3103
Country : US
Telephone Number : 518-426-2726
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2008
Last Update Date : 09/09/2008

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Directions to “ STEVE BANBURY LCSW” Practice Location

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