Carly Banks, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23332 Issued in MD

Practice address

10026 Main St BLDG 1
Berlin, MD 21811-3206

Phone

(410) 973-2211

Fax

(443) 782-0350

NPI assigned

Sep 14, 2016

Last updated

Jul 28, 2021By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lighthouse Counseling Christian Ministry, LLCGroup PAC ID 1456615079, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lighthouse Counseling Christian Ministry, LLC

  • Professional Counselor
  • Berlin, MD
  • NPI 1104272426
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1467900803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10026 MAIN ST BLDG 1",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113206",
            "telephone_number": "410-973-2211",
            "fax_number": "443-782-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10026 MAIN ST BLDG 1",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113206",
            "telephone_number": "410-973-2211",
            "fax_number": "443-782-0350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23704 Ocean Gtwy",
            "address_purpose": "LOCATION",
            "city": "Mardela Springs",
            "state": "MD",
            "postal_code": "218372101",
            "country_code": "US",
            "telephone_number": "410-677-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANKS",
        "first_name": "CARLY",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "G12312",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "23332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "23332",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deontae Bailey
• Joann Bailey
• Jossett Marcia Bailey, RN
• Shardae Bailey
• Thomas Vincent Ballard
• Aimee Barnes, PTA
• Caitlin Barnwell
• Emily Rose Barry
• Caylee Barton, RDH, BSDH
• Annie Belle Bassford

• Clinical Social Worker in Berlin, MD
• Providers in Berlin, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.