Jackie Lynn Fober, LISW
Individual provider Active NPI Social Worker · Waverly, IA
NPI 1851275259 · NPPES record last updated May 12, 2026
Key facts
- NPI
- 1851275259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 02208 (IA)
- Practice address
- 124 2ND St NE
Waverly, IA 50677-1762 - Phone
- (319) 344-4994
- NPI assigned
- Jul 31, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1300 Woodland Ave
West Des Moines, IA 50265-2306
3362 University Ave
Waterloo, IA 50701-2006
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260518000977 | IA | Practitioner - Clinical Social Worker | 5496224693 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathways Behavioral Services Inc | Past | Accepting new patients | |
| Pathways Behavioral Services, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 02208 | IA | Yes |
Addresses
Primary practice location
124 2ND St NE
Waverly, IA 50677-1762
Mailing address
104 Parkview Rd
Denver, IA 50622-1117
Phone (319) 242-1128
Other providers in Waverly, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.