Provider Demographics
NPI:1497078356
Name:BANKS, ADAM (MA, LCSW, CASAC)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BANKS
Suffix:
Gender:M
Credentials:MA, LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 JOHNSON AVE # 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1633
Mailing Address - Country:US
Mailing Address - Phone:929-483-5337
Mailing Address - Fax:
Practice Address - Street 1:115 COLLEGE AVE APT 3E
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2820
Practice Address - Country:US
Practice Address - Phone:929-483-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY0844361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)