Individual
ANITA BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1101 CAROLINA ST, GREENSBORO, NC 27401-1318
(336) 333-6860
(336) 275-1187
Mailing address
6882 DERBY RUN DR, WHITSETT, NC 27377-9825
(828) 280-0349
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
02/25/2026
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