Bancroft G Davis, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS017241 Issued in PA

Practice address

30 S Valley Rd
Suite 101
Paoli, PA 19301

Phone

(267) 674-6621

Fax

(267) 627-6141

NPI assigned

Dec 11, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bright Path Therapy & Associates, LLC.

  • Clinical Psychologist
  • Wayne, PA
  • NPI 1477042562

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1306181797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "19301",
            "telephone_number": "267-674-6621",
            "fax_number": "267-627-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S VALLEY RD",
            "address_2": "SUITE 101",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "19301",
            "telephone_number": "267-674-6621",
            "fax_number": "267-627-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BANCROFT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingeborg Krompholz Damstra, M.D.
• Daniel Malloy-Good
• Jessica Dankanich, MS OTR/L
• David Mark Danoff, MD
• David a. Shields, D.C., P.C.
• Crystal Leigh Davis, MA, LPC
• Vera Davis, CRNP
• Christine M. Day, APRN, AGPCNP-BC
• Daylesford Family Medicine, P.C.
• Marleena Ann Debrough

• Clinical Psychologist in Paoli, PA
• Providers in Paoli, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.