BANCROFT NEUROHEALTH (NPI# 1609321256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609321256 |
| Entity Type | Organization |
| Organization Name | BANCROFT NEUROHEALTH |
| Practice Address |
1255 Caldwell Rd Cherry Hill NJ 08034-3220 |
| Mailing Address |
3900 Church Rd Mount Laurel NJ 08054-1108 |
| Practice Telephone | 8563481175 |
| Practice Fax Number | 8563758358 |
| Mailing Telephone | 8007745516 |
| Mailing Fax Number | 8564294755 |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |
| Authorized Official Name | TONI PERGOLIN (PRESIDENT / CEO) |
| Authorized Official Telephone | 8563481175 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
PRF101 | NJ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | MEDICARE PTAN | 500549 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329336 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 302 Villinger Ave, Cinnaminson, NJ 08077-2934 | 2020-09-03 |
| 1184232175 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 65 Brophy Ct, Ewing, NJ 08638-1224 | 2020-07-16 |
| 1891325908 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 347 Walton Ave, Mount Laurel, NJ 08054-9579 | 2020-01-17 |
| 1891335139 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 993 Shadow Oaks Dr, Toms River, NJ 08753-3531 | 2020-01-15 |
| 1134762065 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1703 Cedar Dr, Medford, NJ 08055-2322 | 2019-10-23 |
| 1932740883 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4104 Hamilton Dr, Voorhees, NJ 08043-3121 | 2019-10-02 |
| 1184187437 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3208 Avalon Ct, Voorhees, NJ 08043-4649 | 2019-04-12 |
| 1285194878 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1811 Kresson Rd, Cherry Hill, NJ 08003-2528 | 2019-03-21 |
| 1164998340 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 707 Eugenia Dr, Medford, NJ 08055-2312 | 2018-10-16 |
| 1972080059 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Hessian Way, Cherry Hill, NJ 08003-2615 | 2018-07-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BANCROFT NEUROHEALTH, A NEW JERSEY NONPROFIT CORPORATION | 1255 Caldwell Rd, Cherry Hill, NJ 08034-3220 |
| Street Address |
1255 CALDWELL RD |
| City | CHERRY HILL |
| State | NJ |
| Zip Code | 08034-3220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992047591 | Bancroft Rehabilitation | Speech-Language Pathologist | 1255 Caldwell Rd, Cherry Hill, NJ 08034 | 2013-03-21 |
| 1962864512 | Sally Ward Fusco | Registered Nurse | 1255 Caldwell Rd, Cherry Hill, NJ 08034-3220 | 2016-03-23 |
| 1992176275 | Meghan L Brennan | Behavioral Analyst | 1255 Caldwell Rd, Cherry Hill, NJ 08034-3220 | 2015-10-13 |
| 1871964155 | Kathleen M Donohoe | Behavioral Analyst | 1255 Caldwell Rd, Cherry Hill, NJ 08034-3220 | 2015-10-13 |
| 1669843942 | Kelly E Dulak | Behavioral Analyst | 1255 Caldwell Rd, Cherry Hill, NJ 08034-3220 | 2015-10-13 |
| 1881064442 | Marcroft Medical Associates, P.C. | Physical Therapist | 1255 Caldwell Rd, Cherry Hill, NJ 08034-3220 | 2015-09-25 |
| 1841682291 | Bancroft | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1255 Caldwell Rd, Cherry Hill, NJ 08034 | 2015-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821606054 | Glickman Psychological Services, LLC | Psychologist | 80 Barclay Center, Suite 4, Cherry Hill, NJ 08034 | 2020-07-14 |
| 1215455225 | Arc of Camden County Millhurst Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 141 Hayes Mill Road, Apt 218, Cherry Hill, NJ 08034 | 2017-08-30 |
| 1144748120 | Arc of Camden County Chanticleer Drive Supported Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 712 Chanticleer Drive, Cherry Hill, NJ 08034 | 2017-08-30 |
| 1124558689 | 1 Choice Home Health Care, LLC | Home Health | 1409 E. Highway 70, Barclay Pavilion, Suite 207w, Cherry Hill, NJ 08034 | 2017-06-18 |
| 1205362621 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 Wayland Rd, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1598291940 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 Brookdale Dr, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1861928285 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 302 Portsmouth Rd, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1265967954 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8 Farmhouse Ln, Maple Shade, NJ 08034 | 2017-05-01 |
| 1023543709 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 407 Cranford Rd, Cherry Hill, NJ 08034 | 2017-05-01 |
| 1588199269 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Colgate Drive, Cherry Hill, NJ 08034 | 2017-05-01 |
| Find all providers in zip 08034 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558996694 | Michael A Jacobs | Psychologist | 711 Marys Dr, Brick, NJ 08723-4213 | 2020-03-10 |
| 1033756648 | Rising Stars Aba LLC | Psychologist | 3 Trudy Ln, Lakewood, NJ 08701-4675 | 2019-12-02 |
| 1598307068 | A Helping Hand Services Inc. | Psychologist | 208 Brandywine Dr., Williamstown, NJ 08094 | 2019-10-16 |
| 1407413297 | Khadija Fofana | Psychologist | 122 Girard Ave, Somerset, NJ 08873-2417 | 2019-05-28 |
| 1598247603 | Lasheima Jefferson | Psychologist | 650 Park Ave Apt 218, East Orange, NJ 07017-1578 | 2018-09-05 |
| 1366973455 | Stacieann Jones | Psychologist | 10 Sandstone Ln, Willingboro, NJ 08046-2004 | 2017-03-21 |
| 1407391022 | Marva Mcintosh | Psychologist | 112 Arbor Dr, Swedesboro, NJ 08085-5050 | 2017-01-05 |
| 1336697614 | Comprehensive Care Network, Ltd Liability Co. | Psychologist | 172 Broadway Rear Building, Woodcliff Lake, NJ 07677-8077 | 2016-09-15 |
| 1295103927 | Vanessa Checo | Psychologist | 940 Flora St, Elizabeth, NJ 07201-1914 | 2015-09-11 |
| 1447671102 | Patricia Louise Irwin | Psychologist | 150 Salem Woodstown Road, Salem, NJ 08079-0005 | 2013-12-26 |
| Find all providers with the same taxonomy | ||||
| City | CHERRY HILL |
| Zip Code | 08034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.