Kimberly Ellen Banach

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

75 Bond Rd
Charlton, MA 01507-1301

Phone

(508) 523-8371

NPI assigned

Sep 14, 2021

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1730859539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BOND RD",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071301",
            "telephone_number": "774-200-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BOND RD",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071301",
            "telephone_number": "508-523-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANACH",
        "first_name": "KIMBERLY",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amma Boaa Asare, PMHNP
• Ashleen Counseling Assoc., Inc.
• Teddi Bachawaty, MD
• Lisa Baldassarre
• Jennifer Morway Balestracci, LICSW, SAC
• Ann L Baniukiewicz, FNP-BC
• Susan Bantu, M.ED. (CHD)
• Zareen Lakhani Barry, NP
• Debra A Bedula, CLINICIAN
• Elias Belezos, M.D.

• Community/Behavioral Health Agency in Charlton, MA
• Providers in Charlton, MA by specialty
• Community/Behavioral Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.