Individual
LAWRENCE ALLEN BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCASA, LCMHCA
Contact information
Practice address
229 CENTURY BLVD APT 47A, KERNERSVILLE, NC 27284-4038
(336) 257-9384
Mailing address
229 CENTURY BLVD APT 47A, KERNERSVILLE, NC 27284-4038
(828) 548-3057
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-27641
NC
101YP2500X
Professional Counselor
Primary
16961
NC
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/06/2021
Last updated
03/11/2026
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