Individual provider Active NPI

Austin R Banks Jr., SPORTS MANAGEMENT

  • Mental Health Counselor
  • Marrero, LA
National Provider Identifier
1720577141
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
14 Gladiola CT
Marrero, LA 70072-2429
Phone
(985) 956-7650
Fax
(985) 956-7561
NPI assigned
May 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

14 Gladiola CT
Marrero, LA 70072-2429

Mailing address

14 Gladiola CT
Marrero, LA 70072-2429
Phone (504) 799-9207

Other identifiers 1

IdentifierTypeStateIssuer
1255681128MedicaidLA

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

NPI Registry JSON

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1720577141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 GLADIOLA CT",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700722429",
            "telephone_number": "504-799-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 GLADIOLA CT",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700722429",
            "telephone_number": "985-956-7650",
            "fax_number": "985-956-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "AUSTIN",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "SPORTS MANAGEMENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255681128",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.