Renee L Bacon, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3470 Issued in CT

Practice address

150 W Main St
Branford, CT 06405-4031

Phone

(203) 318-4220

NPI assigned

Sep 13, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Cornell Scott Hill Health Corporation

  • Multi-Specialty Clinic/Center
  • New Haven, CT
  • NPI 1962477968
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1114577012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054031",
            "telephone_number": "203-318-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054031",
            "telephone_number": "203-318-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "RENEE",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008090423",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Attraversiamo LLC
• Aura Psychotherapy LLC
• Tania Aziz, MD
• Back to Health of Branford, LLC
• Lisa N Backus, PHD
• Robert John Badrigian, DDS
• Lu Bai, CNP
• Ronald J Bailey, DMD
• Sandra L Baker, LO
• Deborah Balisciano, CRNA

• Professional Counselor in Branford, CT
• Providers in Branford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.