Belinda Bacon, PCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-982 Issued in WY

Practice address

4989 N 3Rd St
Laramie, WY 82072-9548

Phone

(307) 745-8997

NPI assigned

Oct 22, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1497008957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4989 N 3RD ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820729548",
            "telephone_number": "307-745-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4989 N 3RD ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820729548",
            "telephone_number": "307-745-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "BELINDA",
        "credential": "PCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "475-PCSW",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WY",
            "license": "PCSW-475",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "LCSW-982",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "475-PCSW",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Aulick, CMT
• Guillermo Agustin Avalos
• Michael Andrew Avalos
• Ellen Virginia Axtmann, LPC
• Erambo Ayokosok, PHARM D
• Tanya Baer
• Ayesha K Baig, PPC
• Austin Baker, PHARMD
• Samanthajo Baker, PMHNP-BC
• Asia Corrine Baldivia

• Clinical Social Worker in Laramie, WY
• Providers in Laramie, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.