Kafunda Banks

Individual provider Active NPI Mental Health Counselor · Randolph, MA

NPI 1003115494 · NPPES record last updated Mar 24, 2011

Key facts

NPI
1003115494
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
41 Pacella Park Dr
Randolph, MA 02368-1755
Phone
(781) 440-0400
NPI assigned
Mar 24, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

41 Pacella Park Dr
Randolph, MA 02368-1755

Mailing address

41 Pacella Park Dr
Randolph, MA 02368-1755
Phone (781) 440-0400

Other identifiers

IdentifierTypeStateIssuer
110026265MedicaidMA

Other providers in Randolph, MA

All providers in Randolph, MA · Mental Health Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.