Kaylyn Banning, BS
Individual provider Active NPI Mental Health Counselor · New London, CT
NPI 1689065013 · NPPES record last updated Feb 6, 2015
Key facts
- NPI
- 1689065013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 255 Hempstead St
New London, CT 06320-6204 - Phone
- (860) 443-2896
- Fax
- (860) 442-5909
- NPI assigned
- Feb 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
34 E Town St
Norwich, CT 06360-2317
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251111000876 | CT | Practitioner - Mental Health Counselor | 3577054261 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3214 | CT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Khalifeh Counseling, LLC | Mental Health | Current | Accepting new patients |
| United Community and Family Services, Inc. | Current |
Accepting new patients |
Locations
70 Main St
Jewett City, CT 06351
Phone (860) 376-7040
47 Town St
Norwich, CT 06360
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
255 Hempstead St
New London, CT 06320-6204
Mailing address
255 Hempstead St
New London, CT 06320-6204
Phone (860) 443-2896
Other providers in New London, CT
- Victoria Ashley Bairos
- Brenda K. Balch
- Eric Balch
- Frank Ball
- Steven Bandtlow
- Dashelle Grant Barco
- Timothy M Barczak
- Marilyn Alexander Barnes
- Marilu Barrientos
- Kathy A Barrio
All providers in New London, CT · Mental Health Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.