Michael Brandon Banks

Individual provider Active NPI Peer Specialist · Louisville, KY

NPI 1386097145 · NPPES record last updated Jul 18, 2016

Key facts

NPI
1386097145
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
950 S 1St St
Louisville, KY 40203-2202
Phone
(502) 585-9444
Fax
(502) 585-9466
NPI assigned
Jul 18, 2016
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgehaven, Inc. Past
since Feb 27, 1997
Accepting new patients
US Psychiatry PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X KY Yes

Addresses

Primary practice location

950 S 1St St
Louisville, KY 40203-2202

Mailing address

950 S 1St St
Louisville, KY 40203-2202
Phone (502) 585-9444

Other providers in Louisville, KY

All providers in Louisville, KY · Peer Specialist in Kentucky

Sources for this page

Verify at the official NPI Registry.