Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derrick Bacon

Individual provider Mental Health Counselor · NPI 1083102180

Derrick Bacon is a Mental Health Counselor in Philadelphia, Pennsylvania. Practices as a sole proprietor. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

906 69th Ave
Philadelphia, PA 19126-2909
Phone: (215) 300-8111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1083102180
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 25, 2018
Last updated in NPPESApril 25, 2018

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