Provider Demographics
NPI:1124645767
Name:BANCROFT, KYLIE EYSE (MSW)
Entity type:Individual
Prefix:MRS
First Name:KYLIE
Middle Name:EYSE
Last Name:BANCROFT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BAY RD APT 3
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1707
Mailing Address - Country:US
Mailing Address - Phone:603-845-8968
Mailing Address - Fax:
Practice Address - Street 1:510 OLD CANDIA RD
Practice Address - Street 2:
Practice Address - City:CANDIA
Practice Address - State:NH
Practice Address - Zip Code:03034-2400
Practice Address - Country:US
Practice Address - Phone:603-810-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health