Provider Demographics
NPI:1699302653
Name:BANKS, VANESSA J (LICSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:J
Last Name:BANKS
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4915 SAINT ELMO AVE STE 506
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-6019
Mailing Address - Country:US
Mailing Address - Phone:301-661-3481
Mailing Address - Fax:800-735-4520
Practice Address - Street 1:4915 SAINT ELMO AVE STE 506
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6019
Practice Address - Country:US
Practice Address - Phone:301-661-3481
Practice Address - Fax:800-735-4520
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500823421041C0700X
MD262641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical