George Albert Bacon Jr., LCMHCS, LCAS

Primary specialty

CounselorTaxonomy code 101Y00000X

License

S9005 Issued in NC

Practice address

2201 Seagrave Dr
Winterville, NC 28590-0119

Phone

(252) 341-2761

NPI assigned

Sep 22, 2022

Last updated

Sep 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Dawn Psychiatric Services PLLCGroup PAC ID 6204159320, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Dawn Psychiatric Services, PLLC

  • Community/Behavioral Health Agency
  • Kinston, NC
  • NPI 1245637701
  Medicare reassignment Care Compare group NPD
• Anesthesia Services Associates, PLLC

  dba Comprehensive Pain Specialists

  • Durable Medical Equipment & Medical Supplies
  • Lexington, KY
  • NPI 1376054213
  NPD (past)

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1609599711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 SEAGRAVE DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285900119",
            "telephone_number": "252-341-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 SEAGRAVE DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285900119",
            "telephone_number": "252-341-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "GEORGE",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCMHCS, LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "S9005",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-2748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aurora Therapeutic and Consultation Services
• Kelly Austin, PHARMD
• Ayden's Transitional Services ,LLC
• Titilola Oluwadara Babatunde
• Kristian Backman, LCSWA
• Shannon Ballard
• Jenna Noelle Barber
• Brice Morse Barnes
• Amy Lavelle Barnwell, MS, NCC, LPCA
• Alisa Barrett

• Counselor in Winterville, NC
• Providers in Winterville, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.