Individual
MS. SOPHIA ROGERS BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
915 RHODE ISLAND AVE NW, WASHINGTON, DC 20001-4153
(202) 232-6100
(202) 644-7024
Mailing address
915 RHODE ISLAND AVE NW, WASHINGTON, DC 20001-4153
(202) 232-6100
(202) 644-7024
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGPC200012610
DC
106S00000X
Behavior Technician
Primary
18-61283
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102113832
CIGNA
NC
Enumeration date
07/24/2018
Last updated
02/07/2026
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