NPI 1093320608

Matthew Banas

Practitioner Mental Health Counselor Lake Geneva, WI

Practice location

Address: 750 Veterans Pkwy Unit 100, Lake Geneva, WI 53147-4950
Phone: (262) 248-7942
Mailing address: 40723 93rd St, Genoa City, WI 53128-1291

Registered specialties

Mental Health Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

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Registry record

NPI: 1093320608
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Sep 2020
Record last updated: 16 Sep 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.