Barbara M. Bacon, LISW-S
Individual provider Active NPI Clinical Social Worker · Medina, OH
NPI 1235486283 · NPPES record last updated Aug 9, 2012
Key facts
- NPI
- 1235486283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0007356-S (OH)
- Practice address
- 3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334 - Phone
- (330) 764-7916
- Fax
- (330) 723-6399
- NPI assigned
- Aug 9, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0007356-S | OH | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0007356-S | OH | Yes |
Addresses
Primary practice location
3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334
Mailing address
3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334
Phone (330) 764-7916
Other providers in Medina, OH
- Axis Home Healthcare, Inc.
- Daphne Christine Ayers
- B G L and Associates, Inc.
- Neneh Haby Ba
- Backbone of Health LLC
- Kaitlin Bagger
- Monica Dolores Bagley
- Shalini Baijal
- Kristin Kay Bailey
- Michael Scott Bailey
All providers in Medina, OH · Clinical Social Worker in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.