MR. ERIC BACON (NPI# 1720320013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720320013 |
Entity Type | Individual |
Full Name | MR. ERIC BACON |
Credential | LADC |
Practice Address |
153 Cesar Chavez St Saint Paul MN 55107-2226 |
Practice Telephone | 6513892540 |
Practice Fax Number | 6516027580 |
Mailing Telephone | 6513892540 |
Mailing Fax Number | 6516027580 |
Enumeration Date | 2013-03-25 |
Last Update Date | 2013-03-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
302461 | MN | Behavioral Health & Social Service Providers |
Street Address |
153 CESAR CHAVEZ ST |
City | SAINT PAUL |
State | MN |
Zip Code | 55107-2226 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104820661 | Carrie S Dickson | Advanced Practice Midwife | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2005-06-10 |
1700493137 | Carolina Gentry | Social Worker | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2020-09-29 |
1740890334 | Quest Diagnostics | Clinical Medical Laboratory | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2020-08-07 |
1316589195 | Sara Saini Maki | Pharmacist | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-10-13 |
1912556457 | Christine Jo Singer | Registered Nurse | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-09-07 |
1831745025 | Antionette Renee Estis | Advanced Practice Midwife | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-08-13 |
1467006700 | Faisa Hassan Abdi-omar | Midwife | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-07-25 |
1790338754 | Mikaela Pierson | Physician Assistant | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-07-18 |
1427519529 | Bright Smiles Dental Program | Clinic/Center | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-03-29 |
1275005464 | Eli Eggen | Pharmacist | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2018-12-28 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477944809 | Marina Castillo | Counselor | 143 Isabel St. W, Saint Paul, MN 55107 | 2015-02-06 |
1134540123 | Michelle M Lee | Social Worker | 106 Water Street/3rd Floor, Umbrella Tree Studios, St. Paul, MN 55107 | 2013-12-18 |
1376748574 | Mary E. A. Horoshak | Physical Therapist | 155 S Wabasha St, Suite 130, St. Paul, MN 55107 | 2007-06-18 |
1821156050 | Amherst H. Wilder Foundation | Assisted Living Facility | 469 Ada St, Saint Paul, MN 55107 | 2006-12-04 |
1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
1780753681 | Chad Randal Vickers | Nurse Practitioner | 135 Colorado Street East, Saint Paul, MN 55107 | 2006-11-06 |
1225122872 | Elizabeth E Frost | Family Medicine | 153 Cesar Chavez Street, St Paul, MN 55107 | 2006-10-03 |
1215457890 | Elizabeth Smith Zaremba | Dietitian, Registered | 205 Wabasha St S, Mail Stop 31300a, St Paul, MN 55107 | 2017-06-23 |
1366819609 | Brittany Leach | Advanced Practice Midwife | 624 Smith Ave S, Saint Paul, MN 55107 | 2015-08-21 |
1003293101 | Huiying Guo | Family Medicine | 205 Wabasha St S, Saint Paul, MN 55107 | 2015-04-28 |
Find all providers in zip 55107 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235736786 | Catherine Ann Jaksha | Counselor | 1180 Cushing Cir Apt 217, Saint Paul, MN 55108-5016 | 2020-10-07 |
1629683388 | Family Recovery Resource Experts LLC | Counselor | 311 Ramsey St Ste 206, Saint Paul, MN 55102-2323 | 2020-09-10 |
1811508120 | Damaris Axelson | Counselor | 69 Exchange St W # G700, Saint Paul, MN 55102-1004 | 2020-08-11 |
1366051344 | Carrie Lois Sorenson | Counselor | 1618 Dayton Ave, Saint Paul, MN 55104-6207 | 2020-07-27 |
1104452564 | Heather Thurmes | Counselor | 555 7th St W Ste 302, Saint Paul, MN 55102-3068 | 2020-03-18 |
1396377206 | Gail Weiss | Counselor | 1821 University Ave W Ste 333, Saint Paul, MN 55104-2895 | 2020-02-08 |
1104456573 | Sarah Ann Licari | Counselor | 455 Etna St, Saint Paul, MN 55106-5859 | 2020-01-24 |
1881230134 | Gregory John Robertson | Counselor | 1380 Energy Ln Ste 203, Saint Paul, MN 55108-5253 | 2019-11-21 |
1225671415 | Sukimo Dolores Knight | Counselor | 1606 Westminster St # 312, Saint Paul, MN 55130-3036 | 2019-10-21 |
1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
Find all providers in SAINT PAUL |
City | SAINT PAUL |
Zip Code | 55107 |
Please comment or provide details below to improve the information on MR. ERIC BACON.
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.