Jefferson H Kraczek, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-27821 Issued in ID

Practice address

4433 Beverland Road
Mackay, ID 83251-8048

Phone

(208) 588-2770

Fax

(208) 588-2984

NPI assigned

Feb 7, 2012

Last updated

Aug 11, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 4 Pillars of Success LLC

  dba Rehabilitative Health Services

  • Multi-Specialty Clinic/Center
  • Ammon, ID
  • NPI 1619134277

  Clinical

  Medicare reassignment NPD
• Idaho Psychological Resources LLC

  • Community/Behavioral Health Agency
  • Mackay, ID
  • NPI 1063918464

  Clinical

  Medicare reassignment NPD
• 4 Pillars of Success LLC

  dba RHS Medical Clinic

  • Clinic/Center
  • Ammon, ID
  • NPI 1457698565
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1093087033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402",
            "city": "MACKAY",
            "state": "ID",
            "postal_code": "832510402",
            "telephone_number": "208-588-2770",
            "fax_number": "208-588-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 BEVERLAND ROAD",
            "city": "MACKAY",
            "state": "ID",
            "postal_code": "832518048",
            "telephone_number": "208-588-2770",
            "fax_number": "208-588-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRACZEK",
        "first_name": "JEFFERSON",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-07",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-27821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Custer SCH Dist #182
• Custer County (South Custer Ambulance)
• Idaho Psychological Resources LLC
• Lost Rivers Medical Center (Mackay Clinic)
• Mountain High Shuttle LLC
• O-Bar Family Dental
• Lori Palmer
• Personal Home Care

• Clinical Social Worker in Mackay, ID
• Providers in Mackay, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.