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

Matthew Marcos Bacca, LSW

Individual provider Social Worker · NPI 1538825922

Matthew Marcos Bacca, LSW is a Clinical Social Worker in Fort Drum, New York. Qualified in 2022, 4 years ago. Licensed in Colorado.

Years since qualifying
4
Licensed in
CO
In the registry since
2021
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

See every abbreviation used in this directory →

Practice location Address checks out

11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438
Phone: (719) 634-8365
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence LSW.009924321 (CO)

Record details

NPI number1538825922
Entity typeIndividual (Type 1)
GenderMale
Credentials LSW
Sole proprietorNo
NPI enumeratedNovember 10, 2021
Last updated in NPPESAugust 11, 2025
Certification dateAugust 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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