| Organization Name: | BANYAN INSTITUTE, INC |
| NPI Number: | 1033259783 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA C NIEBLING (LICENSED MENTAL HEALTH COUNSELOR) |
| Mailing Address: | 11388 Okeechobee Blvd Royal Palm Beach |
| State: | FL US |
| Postal Code: | 334118705 |
| Phone Number: | 5617982310 |
| Fax Number: | 5617982477 |
| NPI Enumeration Date: | 02/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH-4160 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |