KENDALL F BACON MSW NPI 1558344523

NPI Information

NPI: 1558344523
Provider Name: KENDALL F BACON, MSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
915 SOUTH ST
FITCHBURG, MA
ZIP 01420
Phone: (978) 345-4147
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Kendall F Bacon, MSW is a mental health counselor in Fitchburg, MA with 56 years of experience. Kendall F Bacon, MSW NPI is 1558344523. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

915 SOUTH ST
FITCHBURG, MA
ZIP 01420
Phone: (978) 345-4147
Fax: (978) 345-1616

The NPI 1558344523 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/23/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	105716	MASSACHUSETTS	Yes
2	104100000X	Social Worker		105716	MASSACHUSETTS	X
3	106H00000X	Marriage & Family Therapist		105716	MASSACHUSETTS	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P07079	OTHER	MASSACHUSETTS	BCBS
2	127184	OTHER		TRICARE
3	P20100	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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