Individual provider Active NPI

Dashun Tyrell Banks, NCLPCBE

  • Counselor
  • Concord, NC
National Provider Identifier
1972821916
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
11 Union St S # Ll207
Concord, NC 28025-5059
Phone
(919) 672-5005
Fax
(800) 806-0750
NPI assigned
May 14, 2010
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X

Addresses

Primary practice location

11 Union St S # Ll207
Concord, NC 28025-5059

Mailing address

100 Lincoln Rd Apt 921
Miami Beach, FL 33139-2013
Phone (919) 672-5005

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address assured79@hotmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20260214000571 NC Practitioner - Mental Health Counselor 3173003548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Union St S
Concord, NC 28025-5059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11384NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Wellness Addiction (Substance Use Disorder) CurrentSince Jan 20, 2026 Accepting new patients
Clinicians of Mecklenburg Counselor CurrentSince Jun 12, 2022 Accepting new patients

Locations

525 N Tryon St
Charlotte, NC 28202
Phone (704) 559-2069

11 Union St S
Ste 207
Concord, NC 28025
Phone (919) 407-1855

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1972821916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LINCOLN RD APT 921",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392013",
            "telephone_number": "919-672-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UNION ST S # LL207",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255059",
            "telephone_number": "919-672-5005",
            "fax_number": "800-806-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "DASHUN",
        "middle_name": "TYRELL",
        "name_prefix": "Mr.",
        "credential": "NCLPCBE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-14",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "assured79@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "11 Union St S # Ll207",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280255059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.