1. Home
  2. Directory
  3. New York
  4. Commack
  5. Counselor
  6. NPI Profile

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

Active since December 17, 2021PECOS Enrolled
368 VETERANS MEMORIAL HWY STE 3, COMMACK, NY 11725(631) 533-0315 Get Directions Write a Review

NPPES record last updated: March 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 6, 2025, Dec 18, 2024, Sep 10, 2024 and 4 more (7 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 Commack, New York, licensed in New York (012735) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1003575010
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELYN ANGELA JACKSONCredential: LMHC
Location Address368 VETERANS MEMORIAL HWY STE 3Commack, NY 11725-4322
Mailing Address368 Veterans Memorial Hwy Ste 3Commack, NY 11725-4322 · (484) 599-1580
Phone(631) 533-0315
Sole ProprietorNo
Enumeration DateDecember 17, 2021
Last NPPES UpdateMarch 6, 20257 updates tracked since enumeration
NPPES CertifiedMarch 6, 2025
✔ 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
368 VETERANS MEMORIAL HWY STE 3, Commack, NY 11725
Open in Google Maps ↗

Secondary Practice Locations 2

Location 165 Air Park Dr Ste 10Ronkonkoma, NY 11779-7374 · Phone (631) 533-0315
Location 2380 N Broadway Ph EJericho, NY 11753-2198 · Phone (631) 533-0315 · Fax (855) 752-5170

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Maintenance Organization of Florida, UnitedHealthcare.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 20

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

FARIAL ISLAM MHC-LP
Counselor (Mental Health)
368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY 11725
Suffolk County (631) 533-0315
HANNAH LEIGH VAN RONK LMHC
Counselor (Mental Health)
368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY 11725
Suffolk County (631) 533-0315
KRISTI SEDGWICK LMHC
Counselor (Mental Health)
368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY 11725
Suffolk County (631) 533-0315
IAN CONOR MEALIE LMHC
Counselor (Mental Health)
368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY 11725
Suffolk County (631) 533-0315
ROBERT POPP LMHC
Counselor (Mental Health)
368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY 11725
Suffolk County (631) 533-0315
ANGELA PAZ LMHC
Counselor (Mental Health)
368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY 11725
Suffolk County (631) 533-0315
JENNIFER DAVIDSON LMHC
Counselor (Mental Health)
368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY 11725
Suffolk County (631) 533-0315
IRENE VICTORIA BAUTISTA LMHC
Counselor (Mental Health)
368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY 11725
Suffolk County (631) 533-0315

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 368 Veterans Memorial Hwy Ste 3, Commack, NY 11725. The listed phone number is (631) 533-0315.

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 March 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.