| Doctor Name: | RONALD D BANCROFT |
| NPI Number: | 1376712836 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, LPC, LCAS, CCS |
| License Number: | 3242;0151 |
| Business Practice Address: | 417 A First Street Ayden, NC - 28513 |
| Business Phone Number: | 2527465126 |
| Business Fax Number: | |
| Mailing Address: | Po Box 653, AYDEN |
| State: | NC |
| Postal Code: | 28513 |
| Phone Number: | 2527465126 |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2008 |
| NPI Last Update Date: | 02/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 3242;0151 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |