DR. JEAN LAROYCE BACON (NPI# 1184846818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184846818 |
| Entity Type | Individual |
| Full Name | DR. JEAN LAROYCE BACON |
| Credential | PH.D. |
| Practice Address |
83 E Main St Bay Shore NY 11706-8305 |
| Mailing Address |
34 Fire Road Dr Bay Shore NY 11706-3947 |
| Practice Telephone | 6316665067 |
| Practice Fax Number | 6315935472 |
| Mailing Telephone | 6318340388 |
| Mailing Fax Number | 6315935472 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-04-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
045056-1 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02896748 | 05 | |
| NY | MEDICARE PTAN | A400010901 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1735 N Ocean Ave Ste D, Medford, NY 117632671 | 6316665067 |
| Street Address |
83 E MAIN ST |
| City | BAY SHORE |
| State | NY |
| Zip Code | 11706-8305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324562 | Courtney Kay Ocasio | Counselor | 83 E Main St, Bay Shore, NY 11706-8305 | 2020-04-05 |
| 1447893599 | Kyle Viola | Counselor | 83 E Main St, Bay Shore, NY 11706-8305 | 2019-10-22 |
| 1083256580 | Quinn Edward Funn II | Psychologist | 83 E Main St, Bay Shore, NY 11706-8305 | 2019-10-16 |
| 1407416118 | Mary M Kenny Corron | Social Worker | 83 E Main St, Bay Shore, NY 11706-8305 | 2019-06-14 |
| 1417514191 | Deyanira Rivera | Counselor | 83 E Main St, Bay Shore, NY 11706-8305 | 2019-05-28 |
| 1669953758 | Brian R Coyle | Counselor | 83 E Main St, Bay Shore, NY 11706-8305 | 2018-08-27 |
| 1154802817 | Pamela Deborah Gallo | Counselor | 83 E Main St, Bay Shore, NY 11706-8305 | 2018-08-22 |
| 1841737350 | Amanda Ajello | Counselor | 83 E Main St, Bay Shore, NY 11706-8305 | 2017-01-22 |
| 1588974331 | Audrey Lorraine Malcolm | Social Worker | 83 E Main St, Bay Shore, NY 11706-8305 | 2010-10-14 |
| 1023349297 | Butterfly Lcsw PC | Social Worker | 83 E Main St, Bay Shore, NY 11706-8305 | 2010-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598394173 | Erin Marie Barlow | Student in an Organized Health Care Education/Training Program | Southside Emergency Department 301 East Main Street, Bay Shore, NY 11706 | 2020-04-06 |
| 1003460890 | Bay Shore Brightwaters Rescue Ambulance Inc. | Ambulance | 911 Aletta Place, Bay Shore, NY 11706 | 2019-07-30 |
| 1861980872 | Raffy Gutman | Student in an Organized Health Care Education/Training Program | Southside Hospital Family Medicine, 301 E Main St, Bay Shore, NY 11706 | 2018-04-25 |
| 1609371004 | Sengal Kelit Alazar | Student in an Organized Health Care Education/Training Program | South Side Hospital Emergency Department - Northwell, 301 East Main Street, Bay Shore, NY 11706 | 2018-03-27 |
| 1780198671 | Stefany Gabriela Armijos | Social Worker | 144 Fifth Ave, Bay Shore, NY 11706 | 2017-11-30 |
| 1417476771 | Jazmin Unda Jimenez | Licensed Practical Nurse | 236 Adams Ave, Bay Shore, NY 11706 | 2017-09-18 |
| 1013436989 | People Pushers LLC | Non-emergency Medical Transport (VAN) | 50 Corbin Ave, Suite D, Bay Shore, NY 11706 | 2017-09-12 |
| 1871011585 | Life Acupuncture & Massage Therapy P.C. | Acupuncturist | 387 East Main Street Suite 104, Bayshore, NY 11706 | 2017-09-01 |
| 1558881458 | Wilda Novembre | Licensed Practical Nurse | 1742 North Thompson Drive, Bayshore, NY 11706 | 2017-06-21 |
| 1194184085 | Georgette Prawl | Nurse's Aide | 54 1st Avenue, Bayshore, NY 11706 | 2016-02-19 |
| Find all providers in zip 11706 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A 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. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346854775 | Michelle Lynn Lepsis | Social Worker | 5 Sachs St, Bay Shore, NY 11706-6133 | 2020-09-02 |
| 1376086595 | Roanie Taveras | Social Worker | 31 Anna St, Bay Shore, NY 11706-6901 | 2016-11-19 |
| 1063833341 | Ellen Giarraputo | Social Worker | 121 Ocean Ave, Bay Shore, NY 11706-8717 | 2014-01-03 |
| 1720348253 | Recovery Consultant Services | Social Worker | 6 Ackerson St, Bay Shore, NY 11706-7334 | 2012-05-17 |
| 1992092308 | Tomasina Beckford | Social Worker | 112 Cleveland St, Bay Shore, NY 11706-5839 | 2011-07-06 |
| 1700170503 | Melissa Brooke Livingston | Social Worker | 260 Main Street West, Suite 8, Bay Shore, NY 11706 | 2011-06-09 |
| 1932349982 | Lisa Lorraine Stiles | Social Worker | 1295 Boston Ave, Bay Shore, NY 11706-4717 | 2009-03-04 |
| 1982896619 | Laura Asner | Social Worker | 260 W Main St Ste-8, Bay Shore, NY 11706-8322 | 2007-08-16 |
| 1932310208 | Theresa Emily Harkins-jaisle | Social Worker | 1063 Manor Ln, Bay Shore, NY 11706-6224 | 2007-05-25 |
| 1689881336 | Parientes of Suffolk, Lcsw PC | Social Worker | 160 Howells Rd., Bay Shore, NY 11706 | 2007-05-16 |
| Find all providers in BAY SHORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.