Individual
ALICE DARLENE BANCROFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2813 SE MELALEUCA BLVD, PORT SAINT LUCIE, FL 34952-6900
(850) 501-3444
Mailing address
2813 SE MELALEUCA BLVD, PORT SAINT LUCIE, FL 34952-6900
(850) 501-3444
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
SW12588
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
SW12588
FL
101YM0800X
Mental Health Counselor
SW12588
FL
1041C0700X
Clinical Social Worker
Primary
SW12588
FL
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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