JEAN BACON
NPI 1023349297
Social Worker - Clinical in Bay Shore, NY

Q: What is Butterfly Lcsw PC's NPI number?

The NPI number for Butterfly Lcsw PC is 1023349297. It was assigned to this organization in the NPPES registry on January 27, 2010. The provider is doing business as Jean Bacon.

Q: What is Butterfly Lcsw PC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Butterfly Lcsw PC was last updated on April 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 27, 2010

83 E MAIN ST, BAY SHORE, NY 11706(631) 666-5067(631) 593-5472 Get Directions Write a Review

NPPES record last updated: April 14, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Jean Bacon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEAN BACON (NPI 1023349297) is a healthcare organization registered as a clinical in Bay Shore, New York and active in the NPI registry since January 2010. The organization maintains a secondary practice location in Medford and lists Jean Bacon, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1023349297

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameBUTTERFLY LCSW PC

Location Address83 E MAIN STBay Shore, NY 11706-8305

Mailing Address34 Fire Road DrBay Shore, NY 11706-3947 · (631) 666-1951 · Fax (631) 593-5472

Phone(631) 666-5067

Fax(631) 593-5472

Organization SubpartNo

Authorized OfficialJean BaconClinical Director · (631) 666-5067

Enumeration DateJanuary 27, 2010

Last NPPES UpdateApril 14, 2020

NPPES CertifiedApril 14, 2020

✔ NPI 1023349297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NY · 04056

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedSocial WorkerTaxonomy 104100000X · License 076163 (NY), 079274 (NY), 077806 (NY), 070271 (NY), 077805 (NY), 074277 (NY), 079551 (NY), 075977 (NY), 070508 (NY), 073889 (NY), 076780 (NY), 074014 (NY)

83 E MAIN ST, Bay Shore, NY 11706

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Other Names 1

Doing Business AsJean Bacon

Secondary Practice Location 1

Location 11735 N Ocean Ave Ste DMedford, NY 11763-2671 · Phone (631) 666-5067

Other Identifiers 1

OtherA100024503NY · Medicare Group Ptan

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jean Bacon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateNew YorkEnrollment IDO20100408000277Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jean Bacon, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jean Bacon, PH.D.

Clinical Social Worker

NPI 1184846818

83 E MAIN ST
Bay Shore, NY 11706

(631) 666-5067

✔ PECOS✔ Accepts Medicare0.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Butterfly Lcsw PC's NPI number?

The NPI number for Butterfly Lcsw PC is 1023349297. It was assigned to this organization in the NPPES registry on January 27, 2010. The provider is doing business as Jean Bacon.

Where is Butterfly Lcsw PC located?

Butterfly Lcsw PC is located at 83 E Main St, Bay Shore, NY 11706. The listed phone number is (631) 666-5067.

What is Butterfly Lcsw PC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Butterfly Lcsw PC enrolled in Medicare?

Yes. Butterfly Lcsw PC is registered in the Medicare PECOS enrollment system.

When is Butterfly Lcsw PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Butterfly Lcsw PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Butterfly Lcsw PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Butterfly Lcsw PC was last updated on April 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.