Individual provider Active NPI

Simone French Hall Banks, M.ED PSC LCMHC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1194441535
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
15463 Issued in NC
Practice address
5437 Realtree LN
Charlotte, NC 28214-0402
Phone
(708) 717-2489
NPI assigned
Oct 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 15463 NC Primary

Addresses

Primary practice location

5437 Realtree LN
Charlotte, NC 28214-0402

Mailing address

5437 Realtree LN
Charlotte, NC 28214-0402
Phone (708) 717-2489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260602002918 NC Practitioner - Mental Health Counselor 3072084946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 Tidalwalk Dr
Wilmington, NC 28409-4966

3305 Healy Dr
Winston Salem, NC 27103-1406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Banyan Tree Counseling PLLC Mental Health Past Accepting new patients
Solace Counseling & Consulting Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1194441535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5437 REALTREE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282140402",
            "telephone_number": "708-717-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5437 REALTREE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282140402",
            "telephone_number": "708-717-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "SIMONE",
        "middle_name": "FRENCH HALL",
        "name_prefix": "Mrs.",
        "credential": "M.ED PSC LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.