DR. JEAN LAROYCE BACON PH.D. NPI 1184846818

Social Worker (Clinical) in Bay Shore, NY

Individual Female Social Worker Clinical PECOS Enrolled Accepts Medicare Years Experience 29

About JEAN BACON

Jean Bacon is a provider established in Bay Shore, New York and her medical specialization is social worker with more than 29 years of experience. The NPI number of Jean Bacon is 1184846818 and was assigned on May 2007. The practitioner's primary taxonomy code is 1041C0700X with license number 045056-1 (NY). The provider is registered as an individual and her NPI record was last updated April 2020. Jean Bacon is enrolled in PECOS and is registered with Medicare and accepts claims assignment.

NPI

1184846818

Provider NameDR. JEAN LAROYCE BACON PH.D.
Provider Location Address83 E MAIN ST BAY SHORE, NY 11706
Provider Mailing Address34 FIRE ROAD DR BAY SHORE, NY 11706
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1992
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date05-03-2007
Last Update Date04-14-2020

Primary Taxonomy

Taxonomy Code1041C0700X
ClassificationSocial Worker
TypeBehavioral Health & Social Service Providers
SpecializationClinical
License No.045056-1
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

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

Get Directions

Mailing Address

DR. JEAN LAROYCE BACON PH.D.
34 FIRE ROAD DR
BAY SHORE, NY
ZIP 11706
Phone: (631) 834-0388
Fax: (631) 593-5472

Secondary Locations

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

Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare’s enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID4486703808
PECOS Enrollment IDI20090514000135
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
Part B Clinical Laboratory and ImagingYes
Durable Medical EquipmentYes
Home Health Agency (HHA)No
Power Mobility DevicesNo

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 373Psychotherapy, 45 minutes with patient and/or family member (HCPCS:90834)
  • 13Psychiatric diagnostic evaluation (HCPCS:90791)

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
02896748MEDICAID (05)NY
A400010901OTHER (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
1023349297BUTTERFLY LCSW PC
Organization
Social Worker (Clinical)83 E MAIN ST
BAY SHORE, NY 11706
(631) 666-5067
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
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.