Active NPI
Austin R Banks Jr., SPORTS MANAGEMENT
- Mental Health Counselor
- Marrero, LA
National Provider Identifier
1720577141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255681128 | Medicaid | LA |
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.