MR. GREGORY M. BANICKI M.S. ED. NPI 1184785693

NPI Information

  • NPI: 1184785693
  • Provider Name: MR. GREGORY M. BANICKI, M.S. ED.
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1910 SAINT JOE CENTER RD
    FORT WAYNE, IN
    ZIP 46825
  • Phone: (260) 484-5599

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NPI Details

MR. Gregory M. Banicki, M.S. ED. is a mental health counselor in Fort Wayne, IN with 19 years of experience. MR. Gregory M. Banicki, M.S. ED. NPI is 1184785693. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA MEDICAL COLLEGE, SCHOOL OF MEDICINE OF PURDUE UNIVERSITY
Graduation Year:2006

The provider's business location address is:

1910 SAINT JOE CENTER RD
FORT WAYNE, IN
ZIP 46825-000
Phone: (260) 484-5599
Fax: (260) 484-5664

The NPI 1184785693 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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