COURTNEY BACON-LATINA (LPC) – Mental Health Counselor, NPI 1922649532

COURTNEY BACON-LATINA (LPC) is a healthcare provider. based in Malvern, Arkansas. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials LPC. They hold a License No. P2203015 (AR). The NPI Number for COURTNEY BACON-LATINA (LPC) is 1922649532

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
COURTNEY BACON-LATINA (LPC)
NPI
1922649532
Phone
(501) 332-4400
Address
829 HALBERT ST
Enumeration Date
4 October 2019
Last Update Date
1 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5013324400
Graduation Year
2018 (8 years ago)
PAC ID
0840642492
Group Practice PAC ID
3971594052
Professional Enrollment ID
I20240118003523
Address ID
AR721042607MA829XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

11 MARRIAGE AND FAMILY THERAPIST in AR

Provider Addresses for COURTNEY BACON-LATINA (LPC)

  • 829 HALBERT ST

    MALVERN, AR 721042607

    Phone: (501) 332-4400

    Fax: (501) 332-4403

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240118003523IMarriage And Family TherapistARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971594052View full group profile
NameSpecialtyState
Nurse PractitionerAR
Clinical Social WorkerAR
Mental Health CounselorAR
Clinical Social WorkerAR
Mental Health CounselorAR
Orthopedic Surgery, PsychiatryAR
Mental Health CounselorAR

Reviews

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Frequently asked questions

How do payers reference COURTNEY BACON-LATINA (LPC)?
For COURTNEY BACON-LATINA (LPC), use NPI 1922649532 as the unique 10-digit identifier.
Active or inactive — what applies to COURTNEY BACON-LATINA (LPC)?
You should see COURTNEY BACON-LATINA (LPC) as active in CMS-hosted NPPES data.
How would a patient describe COURTNEY BACON-LATINA (LPC)'s focus?
For COURTNEY BACON-LATINA (LPC), the primary taxonomy reads as Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where in Arkansas is COURTNEY BACON-LATINA (LPC) registered?
Use Malvern, Arkansas as the headline location for COURTNEY BACON-LATINA (LPC) here.
When was this NPI issued?
Enumeration for COURTNEY BACON-LATINA (LPC) is noted as October 4, 2019 where the registry provides it.

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