JEAN BACON (BUTTERFLY LCSW PC) NPI 1023349297

Social Worker (Clinical) in Bay Shore, NY

Organization Social Worker Clinical

About JEAN BACON (BUTTERFLY LCSW PC)

Jean Bacon (butterfly Lcsw Pc) is a provider established in Bay Shore, New York specializing in social worker. The NPI number of Jean Bacon (butterfly Lcsw Pc) is 1023349297 and was assigned on January 2010. The practitioner's primary taxonomy code is 1041C0700X with license number 04056 (NY). The provider is registered as an organization and their NPI record was last updated April 2020. Jean Bacon (butterfly Lcsw Pc) operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Jean Bacon. The authorized official of this NPI record is Dr. Jean Bacon Phd, Lcsw (Clinical Director)

NPI

1023349297

Provider NameJEAN BACON (BUTTERFLY LCSW PC)
Provider Location Address83 E MAIN ST BAY SHORE, NY 11706
Provider Mailing Address34 FIRE ROAD DR BAY SHORE, NY 11706
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameJEAN BACON
Other Name TypeDoing Business As (3)
Enumeration Date01-27-2010
Last Update Date04-14-2020

Primary Taxonomy

Taxonomy Code1041C0700X
ClassificationSocial Worker
TypeBehavioral Health & Social Service Providers
SpecializationClinical
License No.04056
License StateNY
Taxonomy DescriptionA 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.

Business Address

JEAN BACON
83 E MAIN ST
BAY SHORE, NY
ZIP 11706
Phone: (631) 666-5067
Fax: (631) 593-5472

Get Directions

Mailing Address

JEAN BACON
34 FIRE ROAD DR
BAY SHORE, NY
ZIP 11706
Phone: (631) 666-1951
Fax: (631) 593-5472

Secondary Locations

1735 N Ocean Ave Ste D
Medford, NY 11763
(631) 666-5067

Authorized Official

Authorized Official NameDR. JEAN BACON PHD, LCSW
Authorized Official TitleCLINICAL DIRECTOR
Authorized Official Phone(631) 666-5067

Group Taxonomy


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

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1104100000XBehavioral Health & Social Service ProvidersSocial Worker076163NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

2104100000XBehavioral Health & Social Service ProvidersSocial Worker079274NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

3104100000XBehavioral Health & Social Service ProvidersSocial Worker077806NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

4104100000XBehavioral Health & Social Service ProvidersSocial Worker070271NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

5104100000XBehavioral Health & Social Service ProvidersSocial Worker077805NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

6104100000XBehavioral Health & Social Service ProvidersSocial Worker074277NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

7104100000XBehavioral Health & Social Service ProvidersSocial Worker079551NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

8104100000XBehavioral Health & Social Service ProvidersSocial Worker075977NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

9104100000XBehavioral Health & Social Service ProvidersSocial Worker070508NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

10104100000XBehavioral Health & Social Service ProvidersSocial Worker073889NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

11104100000XBehavioral Health & Social Service ProvidersSocial Worker076780NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

12104100000XBehavioral Health & Social Service ProvidersSocial Worker074014NYNo

Taxonomy Description: a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
A100024503OTHER (01)NY

Other Providers at the same location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1083256580MR. QUINN EDWARD FUNN II B.A, M.A
Individual
Psychologist (Counseling)83 E MAIN ST
BAY SHORE, NY 11706
(631) 830-7810
1154802817 PAMELA DEBORAH GALLO
Individual
Counselor (Mental Health)83 E MAIN ST
BAY SHORE, NY 11706
(631) 488-3645
1184846818DR. JEAN LAROYCE BACON PH.D.
Individual
Social Worker (Clinical)83 E MAIN ST
BAY SHORE, NY 11706
(631) 666-5067
1407416118 MARY M KENNY CORRON LCSW
Individual
Social Worker (Clinical)83 E MAIN ST
BAY SHORE, NY 11706
(631) 219-4975
1417514191 DEYANIRA RIVERA
Individual
Counselor (Mental Health)83 E MAIN ST
BAY SHORE, NY 11706
(631) 339-0168
1447893599 KYLE VIOLA
Individual
Counselor (Mental Health)83 E MAIN ST
BAY SHORE, NY 11706
(631) 666-5067
1588974331MS. AUDREY LORRAINE MALCOLM LMSW
Individual
Social Worker83 E MAIN ST
BAY SHORE, NY 11706
(347) 645-7202
1669953758 BRIAN R COYLE LMSW
Individual
Counselor83 E MAIN ST
BAY SHORE, NY 11706
(631) 666-1951
1841737350 AMANDA AJELLO
Individual
Counselor (Mental Health)83 E MAIN ST
BAY SHORE, NY 11706
(631) 666-5067
1891324562 COURTNEY KAY OCASIO CMHC
Individual
Counselor (Mental Health)83 E MAIN ST
BAY SHORE, NY 11706
(631) 666-5067

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.