Individual provider Active NPI

Kenneth M. Bancroft, LPCC-S, LICDC-CS

  • Professional Counselor
  • Warren, OH
National Provider Identifier
1649321324
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E0002540-SUPV Issued in OH
Practice address
150 E Market St
Warren, OH 44481-1141
Phone
(330) 399-6451
Fax
(330) 934-6266
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 081074 OH
Social Worker 104100000X S12092 OH
Professional Counselor 101YP2500X E0002540-SUPV OH Primary

Addresses

Primary practice location

150 E Market St
Warren, OH 44481-1141

Mailing address

150 E Market St
Warren, OH 44481-1141
Phone (330) 399-6451

Other practice location 1

318 Mahoning Ave NW
Warren, OH 44483-4605
Phone (330) 395-9563

Other practice location 2

143 Gougler Ave
Kent, OH 44240-2401
Phone (330) 677-4124

Other practice location 3

4970 Belmont Ave
Youngstown, OH 44505-1018
Phone (330) 759-8237

Other identifiers 2

IdentifierTypeStateIssuer
000000125407OtherOHANTHEM
539304000OtherOHMAGELLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081074OHMDAddiction (Substance Use Disorder) Counselor
E0002540-SUPVOHMDProfessional Counselor
S12092OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Community Services Inc CurrentSince Apr 20, 2024 Accepting new patients
Axess Family Services Inc CurrentSince Apr 20, 2024 Accepting new patients
Family & Community Services, Inc Addiction (Substance Use Disorder) CurrentSince Apr 20, 2024 Accepting new patients
Axess Family Services Inc CurrentSince Apr 20, 2024 Accepting new patients
Axess Family Services Inc Current Accepting new patients

Locations

1400 S Arlington St
Unit 38
Akron, OH 44306
Phone (330) 724-5471

390 Robinson Ave
Ste E
Barberton, OH 44203
Phone (330) 564-2697

143 Gougler Ave
Kent, OH 44240
Phone (330) 673-1016

150 E Market St
Warren, OH 44481
Phone (330) 394-6244

318 Mahoning Ave NW
Warren, OH 44483
Phone (330) 394-6342

4970 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-8237

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1649321324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444811141",
            "telephone_number": "330-399-6451",
            "fax_number": "330-934-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444811141",
            "telephone_number": "330-399-6451",
            "fax_number": "330-934-6266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "318 Mahoning Ave NW",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444834605",
            "country_code": "US",
            "telephone_number": "330-395-9563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "143 Gougler Ave",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "OH",
            "postal_code": "442402401",
            "country_code": "US",
            "telephone_number": "330-677-4124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4970 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445051018",
            "country_code": "US",
            "telephone_number": "330-759-8237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANCROFT",
        "first_name": "KENNETH",
        "middle_name": "M.",
        "credential": "LPCC-S, LICDC-CS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "081074",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S12092",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0002540-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000125407",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "539304000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.