Active NPI
Gregory Banka, LPC
- Counselor
- Rio Rancho, NM
National Provider Identifier
1447269147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC: 2379
- Practice address
- 1424 Deborah Rd SE
Suite 202C
Rio Rancho, NM 87124-1058 - Phone
- (505) 859-7734
- Fax
- (505) 859-7602
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC: 2379 | NM | Primary |
Addresses
Primary practice location
1424 Deborah Rd SE
Suite 202C
Rio Rancho, NM 87124-1058
Mailing address
1424 Deborah Rd SE
Suite 202C
Rio Rancho, NM 87124-1058
Phone (505) 859-7734
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 98207326 | Medicaid | NM |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC: 2379 | NM | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319155200000",
"number": "1447269147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1424 DEBORAH RD SE",
"address_2": "SUITE 202C",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241058",
"telephone_number": "505-859-7734",
"fax_number": "505-859-7602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 DEBORAH RD SE",
"address_2": "SUITE 202C",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241058",
"telephone_number": "505-859-7734",
"fax_number": "505-859-7602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANKA",
"first_name": "GREGORY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2011-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NM",
"license": "LPC: 2379",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "98207326",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.