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Individual
KENDALL F BACON
Active
Individual
KENDALL F BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
105716
MA
104100000X
Social Worker
105716
MA
106H00000X
Marriage & Family Therapist
Primary
105716
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127184
TRICARE
—
01
—
P07079
BCBS
MA
Enumeration date
11/23/2005
Last updated
07/13/2026
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