Individual provider Active NPI

Iris Waldon Banks, LCSW

  • Clinical Social Worker
  • Marietta, GA
National Provider Identifier
1255653606
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004119 Issued in GA
Practice address
316 Alexander St SE
Ste. #8
Marietta, GA 30060-8217
Phone
(770) 783-0124
NPI assigned
Feb 25, 2010
Last updated
Feb 25, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW004119 GA Primary

Addresses

Primary practice location

316 Alexander St SE
Ste. #8
Marietta, GA 30060-8217

Mailing address

316 Alexander St SE
Ste. #8
Marietta, GA 30060-8217
Phone (770) 783-0124

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004119GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1255653606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 ALEXANDER ST SE",
            "address_2": "STE. #8",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608217",
            "telephone_number": "770-783-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 ALEXANDER ST SE",
            "address_2": "STE. #8",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608217",
            "telephone_number": "770-783-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "IRIS",
        "middle_name": "WALDON",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; 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.