Zoe Lydia Bacon

Individual provider Active NPI Behavior Technician · Northglenn, CO

NPI 1003374950 · NPPES record last updated Mar 11, 2019

Key facts

NPI
1003374950
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
11698 Huron St Ste 106
Northglenn, CO 80234-2920
Phone
(720) 381-0264
Fax
(303) 984-4366
NPI assigned
Mar 11, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Trumpet Behavioral Health, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

11698 Huron St Ste 106
Northglenn, CO 80234-2920

Mailing address

390 Union Blvd Ste 300
Lakewood, CO 80228-6514
Phone (303) 989-8169

Other providers in Northglenn, CO

All providers in Northglenn, CO · Behavior Technician in Colorado

Sources for this page

Verify at the official NPI Registry.