Individual provider Active NPI

Crystal Banks, M.S. RMHCI

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1003565946
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH24101 Issued in FL
Practice address
3544 Edgewater Dr
Orlando, FL 32804-2922
Phone
(407) 291-8009
Fax
(407) 770-5503
NPI assigned
Mar 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X IMH24101 FL Primary

Addresses

Primary practice location

3544 Edgewater Dr
Orlando, FL 32804-2922

Mailing address

15055 Lake Britt Cir Apt 1201
Winter Garden, FL 34787-7107
Phone (253) 468-1641

Other practice location 1

2808 Enterprise Rd Ste 105
Debary, FL 32713-2753
Phone (386) 259-5413

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
IMH24101FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1003565946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15055 LAKE BRITT CIR APT 1201",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347877107",
            "telephone_number": "253-468-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3544 EDGEWATER DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328042922",
            "telephone_number": "407-291-8009",
            "fax_number": "407-770-5503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2808 Enterprise Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Debary",
            "state": "FL",
            "postal_code": "327132753",
            "country_code": "US",
            "telephone_number": "386-259-5413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANKS",
        "first_name": "CRYSTAL",
        "name_prefix": "Ms.",
        "credential": "M.S. RMHCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-19",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH24101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.