Individual provider · NPI-1

Savannah Marie Bacon, LCSW

Social Worker, Clinical · Rockwall, TX

NPI number1215768452
StatusActive
Last updated in NPPESOct 14, 2026

Details

NPI
1215768452
Entity type
Individual (NPI-1)
Name
Savannah Marie Bacon
Credential
LCSW
Sex
Female
Sole proprietor
No
Enumeration date
Aug 9, 2024
Certification date
Oct 14, 2026
Last updated
Oct 14, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical113344TXYes

Practice location

1005 W Ralph Hall Pkwy Ste 201
Rockwall, TX 75032-6662

Phone 469-545-0160

Mailing address

3618 Dorchester Dr
Rowlett, TX 75088-6580

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