Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jessie A Bacon, LCSW

Individual provider Clinical Social Worker · NPI 1750507604

Jessie A Bacon, LCSW is a Clinical Social Worker in Fort Hall, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2007
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

Mission Road Blding 248 Fort Hall Indian Agency
Fort Hall, ID 83203
Phone: (208) 237-5631
Fax: (208) 237-5796
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-32218 (ID)

Record details

NPI number1750507604
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedApril 18, 2007
Last updated in NPPESMarch 18, 2024
Certification dateMarch 18, 2024

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