Active NPI
Christina Bacon
- Professional Counselor
- Shillington, PA
National Provider Identifier
1376136937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC009769
- Practice address
- 20 W Lancaster Ave
Shillington, PA 19607-1885 - Phone
- (856) 475-7301
- NPI assigned
- Feb 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC009769 | PA | Primary |
Addresses
Primary practice location
20 W Lancaster Ave
Shillington, PA 19607-1885
Mailing address
45 E Broad St
Shillington, PA 19607-2713
Phone (610) 568-0121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC009769 | PA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Insightful Expressions | Professional | Current | Accepting new patients |
Locations
20 W Lancaster Ave
Ste 4
Shillington, PA 19607
Phone (484) 258-9331
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.
-
- Professional Counselor
- Shillington, PA
- NPI 1861183758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722988800000",
"number": "1376136937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 E BROAD ST",
"city": "SHILLINGTON",
"state": "PA",
"postal_code": "196072713",
"telephone_number": "610-568-0121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 W LANCASTER AVE",
"city": "SHILLINGTON",
"state": "PA",
"postal_code": "196071885",
"telephone_number": "856-475-7301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACON",
"first_name": "CHRISTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-15",
"last_updated": "2024-08-07",
"certification_date": "2024-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC009769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.