Individual
MS. LEQUANDRA RANIECE HALE-BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, ACSW
Contact information
Practice address
3721 RIVERDALE RD, MEMPHIS, TN 38115
(901) 334-3144
(901) 334-3145
Mailing address
6118 SUDBURY LN APT 202, MEMPHIS, TN 38115-3335
(901) 612-4359
(888) 721-4071
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
006115
GA
1041C0700X
Clinical Social Worker
Primary
6538
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003151522A
—
GA
05
—
Q046933
—
TN
01
—
Q063320281
MEDICARE
TN
Enumeration date
02/23/2013
Last updated
08/03/2021
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