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KAITLYN RAEME JACOBSEN LMSW
NPI 1962043026
Social Worker - Clinical in Fargo, ND

Active since September 30, 2019PECOS Enrolled
1535 42ND ST S STE 400, FARGO, ND 58103(701) 715-3183 Get Directions Write a Review

NPPES record last updated: March 12, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 12, 2021, Sep 30, 2019 (2 updates tracked since 2019).

About Kaitlyn Raeme Jacobsen Lmsw NPPES

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

KAITLYN RAEME JACOBSEN LMSW (NPI 1962043026) is an individual clinical provider in Fargo, North Dakota and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fargo.

NPPES Registry Identity

NPI1962043026
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKAITLYN RAEME JACOBSENCredential: LMSW
Location Address1535 42ND ST S STE 400Fargo, ND 58103-3383
Mailing Address807 Cinnamon Ridge PlWest Fargo, ND 58078-8190
Phone(701) 715-3183
Sole ProprietorYes
Enumeration DateSeptember 30, 2019
Last NPPES UpdateMarch 12, 20212 updates tracked since enumeration
NPPES CertifiedMarch 12, 2021
✔ NPI 1962043026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
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.
1535 42ND ST S STE 400, Fargo, ND 58103
Open in Google Maps ↗

Secondary Practice Location 1

Location 12701 13th Ave SFargo, ND 58103-3602 · Phone (701) 234-3620

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kaitlyn Raeme Jacobsen Lmsw 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.

Medicare Billing Reassignment

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

Creative Spirit Counseling, PLLC
2.7 mi
Clinical
4675 40TH AVENUE SOUTH, SUITE 120
Fargo, ND 58104
  • Reassigned Medicare billing, North Dakota enrollment
  • 6 clinicians in this Medicare group
NPI 1134779176 (701) 715-8567

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 58103 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 $55.75 – $168.12
Typical copayment $0.00 (range $13.93 – $42.03)
Most-billed visit code NA
Established Patient
$69.48 typical visit price
range $18.11 – $137.65
Typical copayment $17.37 (range $4.52 – $34.41)
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 2

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

JENNIFER KUPFERMAN LMSW
Social Worker
1535 42ND ST S STE 400
FARGO, ND 58103
Cass County (701) 715-8567
JAMES WILLIAM GUERRANT LMSW-CC
Social Worker (Clinical)
1535 42ND ST S STE 400
FARGO, ND 58103
Cass County (701) 715-8567

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 Kaitlyn Jacobsen's NPI number?

The NPI number for Kaitlyn Jacobsen is 1962043026. It was assigned to this individual provider in the NPPES registry on September 30, 2019.

Where is Kaitlyn Jacobsen located?

Kaitlyn Jacobsen practices at 1535 42nd St S Ste 400, Fargo, ND 58103. The listed phone number is (701) 715-3183.

What is Kaitlyn Jacobsen's specialty?

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

Is Kaitlyn Jacobsen enrolled in Medicare?

Yes. Kaitlyn Jacobsen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kaitlyn Jacobsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaitlyn Jacobsen reassigns Medicare benefits to Creative Spirit Counseling, PLLC (Fargo, ND). 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 Kaitlyn Jacobsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kaitlyn Jacobsen accept?

Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Kaitlyn Jacobsen 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 Kaitlyn Jacobsen was last updated on March 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.