Deborah Bannan, LPC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

920 Issued in AK

Practice address

2817 Keenan Dr
Tyler, TX 75701-3706

Phone

(907) 885-5955

NPI assigned

Dec 4, 2015

Last updated

Sep 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Deborah Mangum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Paideia Counseling LLC

  • Community/Behavioral Health Agency
  • Tyler, TX
  • NPI 1043959943
  NPD Authorized official
• Olive Tree Counseling, Inc.

  • Professional Counselor
  • Wasilla, AK
  • NPI 1225268832
  NPD (past)

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1437524204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 KEENAN DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013706",
            "telephone_number": "907-885-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 KEENAN DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013706",
            "telephone_number": "907-885-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNAN",
        "first_name": "DEBORAH",
        "credential": "LPC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-04",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "MANGUM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracey Anelle Banks-Greczanik, D.O.
• Carol Banks, BCBA, LBA
• Jasi Marie Banks, RN
• Jasmine Banks
• Richard C Banks II, EMT-P
• Banner Counseling & Wellness PLLC
• Vikas Bansal, MD
• Elinore Banschbach
• Baptist Care Facilities for Person's With Mental Disabilties (Breckenridge Village of Tyler)
• Nadia Barada, LPC-ASSOCIATE

• Professional Counselor in Tyler, TX
• Providers in Tyler, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.