Dr Jacob Jerry Jackson, PHD, LMHC, CADC - Medicare Counselor in Le Mars, IA

Dr Jacob Jerry Jackson, PHD, LMHC, CADC is a medicare enrolled "Counselor - Mental Health" provider in Le Mars, Iowa. His current practice location is 180 10th St Se Ste 201, Le Mars, Iowa. You can reach out to his office (for appointments etc.) via phone at (712) 546-4624.

Dr Jacob Jerry Jackson is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003366329.

Contact Information

Dr Jacob Jerry Jackson, PHD, LMHC, CADC
180 10th St Se Ste 201,
Le Mars, IA 51031-2557
(712) 546-4624
(712) 546-9395

Healthcare Provider's Profile

Full NameDr Jacob Jerry Jackson
GenderMale
SpecialityCounselor - Mental Health
Location180 10th St Se Ste 201, Le Mars, Iowa
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1003366329
  • Provider Enumeration Date: 10/11/2016
  • Last Update Date: 11/06/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3072962893
  • Enrollment ID: I20231205003305

Medical Identifiers

Medical identifiers for Dr Jacob Jerry Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003366329NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YA0400XCounselor - Addiction (substance Use Disorder) 15081 (Iowa)Secondary
101YM0800XCounselor - Mental Health (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jacob Jerry Jackson allows following entities to bill medicare on his behalf.
Entity NamePlains Area Mental Health Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801867734
PECOS PAC ID: 5395649743
Enrollment ID: O20031126000289

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jacob Jerry Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jacob Jerry Jackson, PHD, LMHC, CADC
180 10th St Se,
Le Mars, IA 51031-2559

Ph: (712) 499-0207
Dr Jacob Jerry Jackson, PHD, LMHC, CADC
180 10th St Se Ste 201,
Le Mars, IA 51031-2557

Ph: (712) 546-4624

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Counselor in Le Mars, IA

Tracy May Delao, T-CADC
Counselor
Medicare: Not Enrolled in Medicare
Practice Location: 180 10th St Se Ste 201, Le Mars, IA 51031
Phone: 712-546-4624    Fax: 712-546-9395
Ms. Kelley Dickey Cuddy, LMHC
Counselor
Medicare: Medicare Enrolled
Practice Location: 180 10th St Se Ste 201, Le Mars, IA 51031
Phone: 712-546-4624    Fax: 712-546-9395
Joshua Van Zweden, CADC
Counselor
Medicare: Not Enrolled in Medicare
Practice Location: 19 Lincoln St Se, Le Mars, IA 51031
Phone: 712-546-7868    Fax: 712-546-7869
Leslie Ann Mohr,
Counselor
Medicare: Not Enrolled in Medicare
Practice Location: 180 10th St Se, Suite 201, Le Mars, IA 51031
Phone: 712-546-4624    
Samantha Graham, LMHC
Counselor
Medicare: Medicare Enrolled
Practice Location: 180 10th St Se Ste 201, Le Mars, IA 51031
Phone: 712-546-4624    
Jill Wonder, LMHC
Counselor
Medicare: Medicare Enrolled
Practice Location: 180 10th St Se Ste 201, Le Mars, IA 51031
Phone: 712-546-4624    Fax: 712-546-9395

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