MEDICARE: MS. LE ANDREA BANKS LCSWC

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
1	1041C0700X	Clinical Social Worker	SW19148	FL
2	1041C0700X	Clinical Social Worker	007332	CT
3	1041C0700X	Clinical Social Worker	14636	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	X2910001	OTHER	MD	CAREFIRST BCBS
3	28438775	OTHER	MD	CIGNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326276312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LE ANDREA BANKS LCSWC

Provider Business Mailing Address
First Line	:	3545 SAINT JOHNS BLUFF RD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-2682
Country	:	US
Telephone Number	:	301-801-4626
Fax Number	:

Provider Business Practice Location Address
First Line	:	3545 SAINT JOHNS BLUFF RD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-2682
Country	:	US
Telephone Number	:	301-801-4626
Fax Number	:	301-576-4554

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2009
Last Update Date	:	09/10/2025

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Directions to “ MS. LE ANDREA BANKS LCSWC” Practice Location

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