Provider Demographics
NPI:1972821916
Name:BANKS, DASHUN TYRELL (NCLPCBE)
Entity type:Individual
Prefix:MR
First Name:DASHUN
Middle Name:TYRELL
Last Name:BANKS
Suffix:
Gender:M
Credentials:NCLPCBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LINCOLN RD APT 921
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2013
Mailing Address - Country:US
Mailing Address - Phone:919-672-5005
Mailing Address - Fax:
Practice Address - Street 1:11 UNION ST S # LL207
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5059
Practice Address - Country:US
Practice Address - Phone:919-672-5005
Practice Address - Fax:800-806-0750
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional