COURTNEY BACON-LATINA (NPI# 1922649532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922649532 |
| Entity Type | Individual |
| Full Name | COURTNEY BACON-LATINA |
| Credential | LAC |
| Practice Address |
829 Halbert St Malvern AR 72104-2607 |
| Practice Telephone | 5013324400 |
| Practice Fax Number | 5013324403 |
| Mailing Telephone | 5013324400 |
| Mailing Fax Number | 5013324403 |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2019-10-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
A1909132 | AR | Behavioral Health & Social Service Providers |
| Street Address |
829 HALBERT ST |
| City | MALVERN |
| State | AR |
| Zip Code | 72104-2607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639180805 | Tfs of Gurdon Inc | Clinic/Center | 829 Halbert St, Malvern, AR 72104-2607 | 2006-08-11 |
| 1245842343 | Kelcey Crutchfield | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2020-08-19 |
| 1477186518 | Joe Bryant | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2020-02-18 |
| 1003449356 | Dayla Rogers | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2020-02-14 |
| 1033740808 | Karen Eason | Counselor | 829 Halbert St, Malvern, AR 72104-2607 | 2020-01-30 |
| 1689231904 | Jennifer Edwards | Counselor | 829 Halbert St, Malvern, AR 72104-2607 | 2019-05-22 |
| 1689144172 | Quinton Revels | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2018-11-28 |
| 1689143133 | Paramount Behavioral Health Inc | Community/Behavioral Health | 829 Halbert St, Malvern, AR 72104-2607 | 2018-11-14 |
| 1528536729 | Jeff Parker | Social Worker | 829 Halbert St, Malvern, AR 72104-2607 | 2018-11-06 |
| 1508359282 | Stephanie Ireland | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2018-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659907707 | Terrence Randell Mitchell | Prosthetist | 991 Mount Willow Rd., Malvern, AR 72104 | 2020-03-20 |
| 1356837959 | American Oncology Partners, P.a. | Internal Medicine | 1001 Schneider Dr Ste 105, Malvern, AR 72104 | 2018-07-06 |
| 1114262839 | Charloda Nolen | Case Manager/Care Coordinator | 1710 E Page, Malvern, AR 72104 | 2012-12-06 |
| 1427349257 | Malvern Physical Therapy and Wellness | Physical Therapist | 1601 Hwy 270 W, Suite 104, Malvern, AR 72104 | 2011-04-27 |
| 1194037069 | Alternative Opportunities | Community/Behavioral Health | 1519 East Page Avenue, Malvern, AR 72104 | 2010-07-08 |
| 1285878991 | Pro-active Rehab Inc. | Physical Therapist | 720 Walco Rd, Suite 240, Malvern, AR 72104 | 2009-04-24 |
| 1932380599 | Vallerie Ahart | Licensed Practical Nurse | 1022 East Page, Malvern, AR 72104 | 2007-11-23 |
| 1104013598 | Vivian Brown | Home Health Aide | 913 Magnolia, Malvern, AR 72104 | 2007-09-28 |
| 1467665919 | Annette Jean Bowersox | Registered Nurse | 1399 Jenny Road, Malvern, AK 72104 | 2007-05-08 |
| 1730305798 | Jacqueline Kilgore LLC | Skilled Nursing Facility | 912 Section Line St, Malvern, AR 72104 | 2007-04-18 |
| Find all providers in zip 72104 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952727554 | Cody Mcarthur | Counselor | 1910 Fox Run, Malvern, AR 72104-9161 | 2014-03-07 |
| 1417254640 | Joy G. Mears | Counselor | 20 Mystic Ln, Suite A, Malvern, PA 19355-1942 | 2011-02-24 |
| 1740486943 | Karen Denise Fry | Counselor | 1022 E Page Ave, Malvern, AR 72104-4362 | 2007-06-25 |
| 1689798993 | Maxus | Counselor | 132 W 2nd St, Malvern, AR 72104-3708 | 2007-03-19 |
| 1114076338 | Tracy E Hill | Counselor | 18 W King St, Malvern, PA 19355-2400 | 2007-01-09 |
| 1457421737 | Desiree Kenyetta Ross | Counselor | 89 Sagewood Dr, Malvern, PA 19355-2234 | 2006-11-08 |
| 1902831399 | Gary D. Kunz | Counselor | 6 Salisbury Ln, Malvern, PA 19355-2836 | 2006-07-12 |
| 1346215324 | Heather Lee Ramsay | Counselor | 580 Riverpark Dr, Malvern, AR 72104 | 2006-02-22 |
| 1154329571 | Linda Carman Copel | Counselor | 2256 Georgetown Dr, Malvern, PA 19355-2308 | 2005-07-10 |
| 1033740808 | Karen Eason | Counselor | 829 Halbert St, Malvern, AR 72104-2607 | 2020-01-30 |
| Find all providers in MALVERN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.