Individual
MS. LISA BANCROFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
4417 BAKER AVE NW, SEATTLE, WA 98107-4352
(253) 330-2694
Mailing address
4417 BAKER AVE NW, SEATTLE, WA 98107-4352
(253) 330-2694
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LW6041704
WA
101YM0800X
Mental Health Counselor
LW6041704
WA
1041C0700X
Clinical Social Worker
Primary
LW6041704
WA
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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