Individual
CARLY BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
10026 MAIN ST BLDG 1, BERLIN, MD 21811-3206
(410) 973-2211
(443) 782-0350
Mailing address
10026 MAIN ST BLDG 1, BERLIN, MD 21811-3206
(410) 973-2211
(443) 782-0350
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
G12312
MD
1041C0700X
Clinical Social Worker
Primary
23332
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23332
LICENSE
MD
Enumeration date
09/14/2016
Last updated
07/28/2021
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