Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Glenn L Banks Jr., MFCT, LISAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1053580381

Mr. Glenn L Banks Jr., MFCT, LISAC is an Addiction (Substance Use Disorder) Counselor in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2008.

Licensed in
AZ
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

18444 N 25th Ave Ste 210
Phoenix, AZ 85023-1264
Phone: (666) 974-2673
Fax: (866) 939-2673
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Psychologist (primary) Taxonomy 103TA0400X · Licence LISAC-10525 (AZ)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 10525 (AZ)

Record details

NPI number1053580381
Entity typeIndividual (Type 1)
GenderMale
Credentials MFCT , LISAC
Sole proprietorNo
NPI enumeratedFebruary 20, 2008
Last updated in NPPESSeptember 6, 2022
Certification dateSeptember 6, 2022

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