Jenna Bancroft, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123376 Issued in MA

Practice address

431 River St Ste 1
Waltham, MA 02453

Phone

(781) 891-0556

NPI assigned

May 31, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1366970667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 RIVER ST STE 1",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535483",
            "telephone_number": "781-891-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 RIVER ST STE 1",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02453",
            "telephone_number": "781-891-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANCROFT",
        "first_name": "JENNA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "223676",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "123376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Long Baker, MS, CCC-SLP
• Julia Anna Baker, WHNP-BC, AGPCNP-BC
• Madelyn Baker
• Devasena Balasubramaniam, M.D.
• Laura M Balducci, MAOM
• Heena Banker, M.D.
• Omari Banner
• Mary S Bannon, NP
• Barbara J Doyle Counseling Services Professional LLC
• Marygrace Davie Barber, N.P.

• Clinical Social Worker in Waltham, MA
• Providers in Waltham, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.