Provider Demographics
NPI:1588385546
Name:BANKS, KATHLEEN KELLY
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:KELLY
Last Name:BANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 772
Mailing Address - Street 2:
Mailing Address - City:S EGREMONT
Mailing Address - State:MA
Mailing Address - Zip Code:01258-0772
Mailing Address - Country:US
Mailing Address - Phone:413-528-5961
Mailing Address - Fax:
Practice Address - Street 1:CSO
Practice Address - Street 2:877 SOUTH STREET, SUITE 200
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-236-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health