Basic Information
Provider Information
NPI: 1144630021
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BANKES
FirstName: SHARON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC,CRC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1592 GRANVILLE PIKE
Address2:  
City: LANCASTER
State: OH
PostalCode: 431301076
CountryCode: US
TelephoneNumber: 7406870835
FaxNumber: 7406879391
Practice Location
Address1: 1592 GRANVILLE PIKE
Address2:  
City: LANCASTER
State: OH
PostalCode: 431301076
CountryCode: US
TelephoneNumber: 7406870835
FaxNumber: 7406879391
Other Information
ProviderEnumerationDate: 05/01/2014
LastUpdateDate: 05/01/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XC1200383OHY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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