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NPI Code Detail

MEDICARE: JANAY BANKSTON

MEDICARE: JANAY BANKSTON
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 Worker
2171M00000XCase Manager/Care Coordinator
31041C0700XClinical Social WorkerI.220362OH

General Provider Information

NPI Number : 1144735358
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANAY BANKSTON
Provider Business Mailing Address
First Line : PO BOX 25772
Second Line :
City : CLEVELAND
State : OH
Zip : 44125-0772
Country : US
Telephone Number : 216-302-8983
Fax Number :
Provider Business Practice Location Address
First Line : 3030 EUCLID AVE STE 212B
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2518
Country : US
Telephone Number : 216-302-8983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2017
Last Update Date : 03/16/2023

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Directions to “ JANAY BANKSTON ” Practice Location

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