Individual provider Active NPI

Jessaca Ann Cassady, LCSW, LAC

  • Clinical Social Worker
  • Bayfield, CO
National Provider Identifier
1255644753
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW-1610 Issued in CO
Practice address
1328 County Road 501
Bayfield, CO 81122
Phone
(970) 903-3354
Fax
(970) 884-5004
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW-1610 CO Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD-0639 CO

Addresses

Primary practice location

1328 County Road 501
Bayfield, CO 81122

Mailing address

3696 County Road 502
Bayfield, CO 81122-9016
Phone (970) 903-3354

Other practice location 1

405 Browning Ave
Ignacio, CO 81137
Phone (970) 903-3354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20110504000760 CO Practitioner - Clinical Social Worker 8123203262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1328 County Rd
Suite 501
Bayfield, CO 81122-9346
Phone (970) 903-3354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD-0639COMDAddiction (Substance Use Disorder) Counselor
CSW-1610COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Coaching and Counseling, LLC Clinical CurrentSince Aug 7, 2018 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1255644753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3696 COUNTY ROAD 502",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811229016",
            "telephone_number": "970-903-3354",
            "fax_number": "970-884-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 COUNTY ROAD 501",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "81122",
            "telephone_number": "970-903-3354",
            "fax_number": "970-884-5004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Browning Ave",
            "address_purpose": "LOCATION",
            "city": "Ignacio",
            "state": "CO",
            "postal_code": "81137",
            "country_code": "US",
            "telephone_number": "970-903-3354",
            "fax_number": "970-442-4511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASSADY",
        "first_name": "JESSACA",
        "middle_name": "ANN",
        "credential": "LCSW, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2022-12-01",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW-1610",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD-0639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayfield, CO

Sources for this page

Verify at the official NPI Registry.