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DERRICK BACON
NPI 1083102180
Counselor - Mental Health in Philadelphia, PA

Active since April 25, 2018
906 69TH AVE, PHILADELPHIA, PA 19126(215) 300-8111 Get Directions Write a Review

NPPES record last updated: April 25, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Derrick Bacon NPPES

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

DERRICK BACON (NPI 1083102180) is an individual mental health provider in Philadelphia, Pennsylvania and active in the NPI registry since April 2018.

NPPES Registry Identity

NPI1083102180
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDERRICK BACON
Location Address906 69TH AVEPhiladelphia, PA 19126-2909
Mailing Address906 69th AvePhiladelphia, PA 19126-2909 · (215) 300-8111
Phone(215) 300-8111
Sole ProprietorYes
Enumeration DateApril 25, 2018
✔ NPI 1083102180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
906 69TH AVE, Philadelphia, PA 19126
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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 Derrick Bacon's NPI number?

The NPI number for Derrick Bacon is 1083102180. It was assigned to this individual provider in the NPPES registry on April 25, 2018.

Where is Derrick Bacon located?

Derrick Bacon practices at 906 69th Ave, Philadelphia, PA 19126. The listed phone number is (215) 300-8111.

What is Derrick Bacon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Derrick Bacon was last updated on April 25, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.