Active NPI
Kenneth M. Bancroft, LPCC-S, LICDC-CS
- Professional Counselor
- Warren, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E0002540-SUPV
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000125407 | Other | OH | ANTHEM |
| 539304000 | Other | OH | MAGELLAN |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 081074 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| E0002540-SUPV | OH | MD | Professional Counselor |
| S12092 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family & Community Services Inc | Current | Accepting new patients | |
| Axess Family Services Inc | Current | Accepting new patients | |
| Family & Community Services, Inc | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Axess Family Services Inc | Current | 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.
-
- Federally Qualified Health Center (FQHC)
- Barberton, OH
- NPI 1356604680
-
- Federally Qualified Health Center (FQHC)
- Ravenna, OH
- NPI 1437944923
-
- Federally Qualified Health Center (FQHC)
- Akron, OH
- NPI 1548214935
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Warren, OH
- NPI 1750607057
-
- Addiction (Substance Use Disorder) Counselor
- Kent, OH
- NPI 1952662108
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.