Individual provider · Type 1 NPI

Jessie A. Bacon, LCSW

Clinical Social Worker · Fort Hall, ID

NPI number 1750507604 Active

Practice location

Mission Road Blding 248, Fort Hall Indian Agency
Fort Hall, ID 83203

Call (208) 237-5631 Map

Fax (208) 237-5796

Mailing address

1068 E Reservation Rich Ln
Blackfoot, ID 83221-7052

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XLCSW-32218 (ID)

Clinical Social Worker: 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 interpers…

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About NPI 1750507604

Jessie A. Bacon, LCSW's National Provider Identifier is 1750507604, issued on Apr 18, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fort Hall, ID. The record was last updated on Mar 18, 2024.