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JESSIE A BACON LCSW
NPI 1750507604
Social Worker - Clinical in Fort Hall, ID

Active since April 18, 2007PECOS Enrolled
MISSION ROAD BLDING 248, FORT HALL INDIAN AGENCY, FORT HALL, ID 83203(208) 237-5631(208) 237-5796 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jessie A Bacon Lcsw NPPES

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

JESSIE A BACON LCSW (NPI 1750507604) is an individual clinical provider in Fort Hall, Idaho, licensed in Idaho (LCSW-32218) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750507604
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJESSIE A BACONCredential: LCSW
Location AddressMISSION ROAD BLDING 248, FORT HALL INDIAN AGENCYFort Hall, ID 83203
Mailing Address1068 E Reservation Rich LnBlackfoot, ID 83221-7052 · (208) 681-6980
Phone(208) 237-5631
Fax(208) 237-5796
Sole ProprietorYes
Enumeration DateApril 18, 2007
Last NPPES UpdateMarch 18, 2024
NPPES CertifiedMarch 18, 2024
✔ NPI 1750507604 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 ID · LCSW-32218
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.
MISSION ROAD BLDING 248, Fort Hall, ID 83203
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessie A Bacon Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83203 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 $52.44 – $160.17
Typical copayment $0.00 (range $13.11 – $40.04)
Most-billed visit code NA
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
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

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

MS. KRISTY LEE BRONCHO LCSW
Social Worker (Clinical)
MISSION ROAD BLDING 248, FORT HALL INDIAN AGENCY
FORT HALL, ID 83203
Bingham County (208) 237-5631

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 Jessie Bacon's NPI number?

The NPI number for Jessie Bacon is 1750507604. It was assigned to this individual provider in the NPPES registry on April 18, 2007.

Where is Jessie Bacon located?

Jessie Bacon practices at Mission Road Blding 248 Fort Hall Indian Agency, Fort Hall, ID 83203. The listed phone number is (208) 237-5631.

What is Jessie Bacon's specialty?

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

Is Jessie Bacon enrolled in Medicare?

Yes. Jessie Bacon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jessie Bacon was last updated on March 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.