Active NPI
Lawrence Allen Bacon, LCASA, LCMHCA
- Professional Counselor
- Kernersville, NC
National Provider Identifier
1376211193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 16961
- Practice address
- 229 Century Blvd Apt 47a
Kernersville, NC 27284-4038 - Phone
- (336) 257-9384
- NPI assigned
- Sep 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 16961 | NC | Primary |
Addresses
Primary practice location
229 Century Blvd Apt 47a
Kernersville, NC 27284-4038
Mailing address
229 Century Blvd Apt 47a
Kernersville, NC 27284-4038
Phone (828) 548-3057
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 |
|---|---|---|---|
| 16961 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773187200000",
"number": "1376211193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 CENTURY BLVD APT 47A",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272844038",
"telephone_number": "828-548-3057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 CENTURY BLVD APT 47A",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272844038",
"telephone_number": "336-257-9384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACON",
"first_name": "LAWRENCE",
"middle_name": "ALLEN",
"credential": "LCASA, LCMHCA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-06",
"last_updated": "2026-03-11",
"certification_date": "2026-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "16961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.