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NPI Code Detail

MEDICARE: DAVID JONATHAN BANKS LPC

MEDICARE: DAVID JONATHAN BANKS LPC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2106H00000XMarriage & Family Therapist25AK
3106H00000XMarriage & Family Therapist
4101YP2500XProfessional Counselor119540AK

General Provider Information

NPI Number : 1740729276
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID JONATHAN BANKS LPC
Provider Business Mailing Address
First Line : 5005 KOBUK AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2403
Country : US
Telephone Number : 907-802-8698
Fax Number :
Provider Business Practice Location Address
First Line : 517 W NORTHERN LIGHTS BLVD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2503
Country : US
Telephone Number : 907-802-8698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2017
Last Update Date : 03/05/2022

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