Individual
MS. STACY LYNN BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
L5777
OR
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
L5777
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500656365
—
OR
Enumeration date
11/12/2007
Last updated
01/29/2026
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