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NPI Code Detail

MEDICARE: HALEY ANN BACON

MEDICARE: HALEY ANN BACON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-23-305690TN
2106E00000XAssistant Behavior Analyst0-25-16388IN
3103K00000XBehavior Analyst1-26-87862IN

General Provider Information

NPI Number : 1710785597
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY ANN BACON
Provider Business Mailing Address
First Line : 1209 W MAIN ST
Second Line :
City : GRIFFITH
State : IN
Zip : 46319-2620
Country : US
Telephone Number : 219-765-2242
Fax Number :
Provider Business Practice Location Address
First Line : 4840 GRASSELLI ST
Second Line :
City : EAST CHICAGO
State : IN
Zip : 46312-3503
Country : US
Telephone Number : 219-397-1085
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2025
Last Update Date : 03/09/2026

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Directions to “ HALEY ANN BACON ” Practice Location

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