MEDICARE: DR. PATRICIA G BANK PH.D., LISW-CP

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
2	1041C0700X	Clinical Social Worker	6091	SC

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

General Provider Information

NPI Number	:	1700909686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA G BANK PH.D., LISW-CP

Provider Business Mailing Address
First Line	:	3710 LANDMARK DR STE 204A
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4034
Country	:	US
Telephone Number	:	803-360-3376
Fax Number	:

Provider Business Practice Location Address
First Line	:	3710 LANDMARK DR STE 204A
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4034
Country	:	US
Telephone Number	:	803-360-3376
Fax Number	:

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

Provider Enumeration Date	:	04/07/2007
Last Update Date	:	03/12/2021

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Directions to “ DR. PATRICIA G BANK PH.D., LISW-CP” Practice Location

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