Provider Demographics
NPI:1184835670
Name:RHODA BANKS LCSW LLC
Entity type:Organization
Organization Name:RHODA BANKS LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-790-1664
Mailing Address - Street 1:246 FEDERAL RD
Mailing Address - Street 2:UNIT C-33
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2647
Mailing Address - Country:US
Mailing Address - Phone:203-775-6269
Mailing Address - Fax:203-740-7887
Practice Address - Street 1:246 FEDERAL RD
Practice Address - Street 2:UNIT C-33
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2647
Practice Address - Country:US
Practice Address - Phone:203-775-6269
Practice Address - Fax:203-740-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004155104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT163042OtherVALUEOPTIONS ID#
CT004231601Medicaid
CT163042OtherVALUEOPTIONS ID#