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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACI PESSETTO
NPI 1619648615
Social Worker - Clinical in Clinton, UT

Active since September 21, 2021PECOS Enrolled
1477 N 2000 W, CLINTON, UT 84015(801) 773-4840(801) 525-8151 Get Directions Write a Review

NPPES record last updated: November 3, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 3, 2026, Sep 21, 2021 (2 updates tracked since 2021).

About Jaci Pessetto NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACI PESSETTO (NPI 1619648615) is an individual clinical provider in Clinton, Utah, licensed in Utah (13403293-3501) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1619648615
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJACI PESSETTO
Location Address1477 N 2000 WClinton, UT 84015-8638
Mailing AddressPo Box 337Layton, UT 84041-0337 · (801) 773-4840 · Fax (801) 525-8151
Phone(801) 773-4840
Fax(801) 525-8151
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateSeptember 21, 2021
Last NPPES UpdateNovember 3, 20262 updates tracked since enumeration
NPPES CertifiedNovember 3, 2026
✔ NPI 1619648615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in UT · 13403293-3501
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1477 N 2000 W, Clinton, UT 84015
Open in Google Maps ↗

Other Names 1

Former Name (1)Jaci Faulkner Lcsw

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, BridgeSpan Health Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaci Pessetto is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860918646
PECOS Enrollment IDI20250424001249
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jaci Pessetto reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tanner Memorial Clinic
Same address
Family Medicine
1477 N 2000 W STE C
Clinton, UT 84015
  • Reassigned Medicare billing, Utah enrollment
  • 270 clinicians in this Medicare group
NPI 1801364369 (801) 773-4840

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84015 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.34 – $166.03
Typical copayment $0.00 (range $13.58 – $41.50)
Most-billed visit code NA
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. COLLETTE CAMPBELL RENSTROM NP-C
Nurse Practitioner (Family)
1477 N 2000 W
CLINTON, UT 84015
Davis County (801) 774-8888
MRS. HAILEY RUSSELL DNP, FNP
Nurse Practitioner (Family)
1477 N 2000 W
CLINTON, UT 84015
Davis County (801) 773-4840
ADAM SCHWEBACH INC
Clinical Neuropsychologist
1477 N 2000 W, SUITE E
CLINTON, UT 84015
Davis County (801) 614-5866
DR. TYLER CARNAHAN DIXON D.O.
Family Medicine
1477 N 2000 W
CLINTON, UT 84015
Davis County (801) 773-4840
JENNY MARIE MORALES SLP
Speech-Language Pathologist
1477 N 2000 W, SUITE E
CLINTON, UT 84015
Davis County (801) 614-5866
DIANA BATTRICK PA-C
Physician Assistant
1477 N 2000 W
CLINTON, UT 84015
Davis County (801) 773-4840
ASHLEY GILLIES
Social Worker (Clinical)
1477 N 2000 W
CLINTON, UT 84015
Davis County (801) 773-4840
MARK S JORGENSEN MD
Family Medicine
1477 N 2000 W
CLINTON, UT 84015
Davis County (801) 773-4840

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaci Pessetto's NPI number?

The NPI number for Jaci Pessetto is 1619648615. It was assigned to this individual provider in the NPPES registry on September 21, 2021. The provider is also known as Jaci Faulkner Lcsw.

Where is Jaci Pessetto located?

Jaci Pessetto practices at 1477 N 2000 W, Clinton, UT 84015. The listed phone number is (801) 773-4840.

What is Jaci Pessetto's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jaci Pessetto enrolled in Medicare?

Yes. Jaci Pessetto is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jaci Pessetto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jaci Pessetto reassigns Medicare benefits to Tanner Memorial Clinic (Clinton, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jaci Pessetto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jaci Pessetto accept?

Health plans from Ambetter Health, Ambetter from Sunflower Health Plan, BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and Select Health and 1 other insurer list Jaci Pessetto as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jaci Pessetto was last updated on November 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.