DR. SAMMY F. BANAWAN (NPI# 1215027156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215027156 |
| Entity Type | Individual |
| Full Name | DR. SAMMY F. BANAWAN |
| Credential | PH.D. |
| Practice Address |
1411 Broad St Durham NC 27705-3534 |
| Practice Telephone | 9193088675 |
| Mailing Telephone | 9193088675 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-06-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
3234 | NC | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3234 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS PROVIDER NUMBER | 046X7 | 01 |
| Street Address |
1411 BROAD ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-3534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437540218 | Peter Perlman | Social Worker | 1411 Broad St, Durham, NC 27705-3534 | 2015-02-14 |
| 1649695941 | Andrea Savage L.c.s.w., P.C. | Social Worker | 1411 Broad St, Durham, NC 27705-3534 | 2014-02-23 |
| 1427375773 | Amelia Hube | Social Worker | 1411 Broad St, Durham, NC 27705-3534 | 2010-04-27 |
| 1407041239 | Andrea Lynn Savage | Social Worker | 1411 Broad St, Durham, NC 27705-3534 | 2007-09-14 |
| 1699988253 | Meggan A Moorhead | Psychologist | 1411 Broad St, Durham, NC 27705-3534 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708062 | Daniel Vanhoy Blalock | Psychologist | 411 W Chapel Hill St Ste 600, Durham, NC 27701-3270 | 2020-10-20 |
| 1265048342 | Joseph Giles Winger | Psychologist | 2200 W Main St Erwin Square Plaza, Durham, NC 27710-0001 | 2020-09-23 |
| 1124640537 | Katherine Ramos | Psychologist | 2200 W Main St Ste 300, Durham, NC 27705-4677 | 2020-05-08 |
| 1902436496 | Caitlin Marie Fang | Psychologist | 1200 Broad St Ste 103, Durham, NC 27705-3576 | 2020-01-23 |
| 1194376095 | Craig Daniel Libman | Psychologist | 508 Fulton St Dept 116b, Durham, NC 27705-3875 | 2019-09-23 |
| 1790346617 | Timothy Joseph Strauman | Psychologist | 708 Ivy Meadow Ln, Durham, NC 27707-6183 | 2019-06-21 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1881150795 | Courtney Dutton Cox | Psychologist | 508 Fulton St # 116c, Durham, NC 27705-3875 | 2019-02-15 |
| 1295290104 | Sarah E. Frost | Psychologist | 18 W Colony Pl Ste 280, Durham, NC 27705-5582 | 2019-02-05 |
| 1134639362 | Mark Edward Wolever | Psychologist | 1502 Nc Hwy 54 Wesst, Suite 406, Durham, NC 27707 | 2017-10-02 |
| Find all providers in DURHAM | ||||
Please comment or provide details below to improve the information on DR. SAMMY F. BANAWAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.