Individual
KIMBERLY ELAINE BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6500 BYRON CENTER AVE SW STE 300, BYRON CENTER, MI 49315-9083
(616) 281-6382
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015256
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301015256
MI
Other
Enumeration date
07/08/2009
Last updated
03/04/2026
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