BRACE BACON
NPI 1801505367
Marriage & Family Therapist in Los Angeles, CA

Q: What is Brace Bacon's NPI number?

The NPI number for Brace Bacon is 1801505367. It was assigned to this individual provider in the NPPES registry on November 23, 2022.

Q: What is Brace Bacon's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: Is Brace Bacon enrolled in Medicare?

No. Brace Bacon has opted out of Medicare through March 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Brace Bacon was last updated on November 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 November 23, 2022Opted out of Medicare · through Mar 12, 2028

11710 SAN VICENTE BLVD, LOS ANGELES, CA 90049(323) 405-7255 Get Directions Write a Review

NPPES record last updated: November 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Brace Bacon NPPES

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

BRACE BACON (NPI 1801505367) is an individual marriage & family therapist in Los Angeles, California and active in the NPI registry since November 2022. He has opted out of Medicare through March 12, 2028.

NPPES Registry Identity

NPI1801505367

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameBRACE BACON

Location Address11710 SAN VICENTE BLVDLos Angeles, CA 90049-5006

Mailing Address1011 Palm Ave Apt 301West Hollywood, CA 90069-4092

Phone(323) 405-7255

Sole ProprietorNo

Enumeration DateNovember 23, 2022

NPPES CertifiedNovember 22, 2022

✔ NPI 1801505367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

11710 SAN VICENTE BLVD, Los Angeles, CA 90049

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Brace Bacon has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 12, 2024 through March 12, 2028.

Opt-Out Effective DateMarch 12, 2024

Opt-Out In Effect ThroughMarch 12, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARTIKA MARIE NAAR-TUCKER LCSW

Social Worker (Clinical)