Provider Demographics
NPI:1194441535
Name:BANKS, SIMONE FRENCH HALL (MED PSC LCMHC)
Entity type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:FRENCH HALL
Last Name:BANKS
Suffix:
Gender:F
Credentials:MED PSC LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5437 REALTREE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-0402
Mailing Address - Country:US
Mailing Address - Phone:708-717-2489
Mailing Address - Fax:
Practice Address - Street 1:5437 REALTREE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-0402
Practice Address - Country:US
Practice Address - Phone:708-717-2489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health