Individual provider · Type 1 NPI

Keith Banta, LCSW

Mental Health Counselor · Louisville, KY

NPI number 1861547218 Active

Practice location

3430 Newburg Rd, Suite 212
Louisville, KY 40218-2497

Fax (502) 736-0140

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X1194 (KY)

Mental Health Counselor: Definition to come...

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About NPI 1861547218

Keith Banta, LCSW's National Provider Identifier is 1861547218, issued on Jan 24, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Louisville, KY. The record was last updated on Jul 8, 2007.