Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACQUELYN ANGELA JACKSON LMHC
NPI 1003575010
Counselor - Mental Health in Huntington Station, NY

Active since December 17, 2021PECOS Enrolled
172 W 21ST ST, HUNTINGTON STATION, NY 11746(631) 209-7883 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 17, 2026, Mar 6, 2025, Dec 18, 2024 and 5 more (8 updates tracked since 2021).

About Jacquelyn Angela Jackson Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELYN ANGELA JACKSON LMHC (NPI 1003575010) is an individual mental health provider in Huntington Station, New York, licensed in New York (012735) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003575010
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELYN ANGELA JACKSONCredential: LMHC
Location Address172 W 21ST STHuntington Station, NY 11746-2122
Mailing Address3 Winterbrooke RdMoodus, CT 06469-1190 · (631) 209-7883
Sole ProprietorNo
Enumeration DateDecember 17, 2021
Last NPPES UpdateSeptember 17, 20268 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2026
✔ NPI 1003575010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 012735
172 W 21ST ST, Huntington Station, NY 11746

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacquelyn Angela Jackson Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Mental Health (Including Community Mental Health Center))
172 W 21ST ST
HUNTINGTON STATION, NY 11746

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacquelyn Jackson's NPI number?

The NPI number for Jacquelyn Jackson is 1003575010. It was assigned to this individual provider in the NPPES registry on December 17, 2021.

Where is Jacquelyn Jackson located?

Jacquelyn Jackson practices at 172 W 21st St, Huntington Station, NY 11746. The listed phone number is (631) 209-7883.

What is Jacquelyn Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jacquelyn Jackson enrolled in Medicare?

Yes. Jacquelyn Jackson is registered in the Medicare PECOS enrollment system.

What insurance does Jacquelyn Jackson accept?

Health plans from Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Jacquelyn Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacquelyn Jackson was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.