JACQUELYN ANGELA JACKSON LMHC
NPI 1003575010
Counselor - Mental Health in Huntington Station, NY
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
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacquelyn Angela Jackson Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jacquelyn Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Commack, NY 11725
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Sean Tendler Mental Health Counseling PC
- 26 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organization bills Medicare for Jacquelyn Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Jackson reassigns Medicare benefits to Sean Tendler Mental Health Counseling, P.C. (Commack, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacquelyn Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacquelyn Jackson accept?
Health plans from Oscar Health, 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 40 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.
# Jacquelyn Angela Jackson, LMHC · NPI 1003575010
Mental Health provider in Huntington Station, New York. Individual provider, active in the CMS NPPES registry since December 17, 2021.
## Identity
- **NPI:** 1003575010 (Entity type: Individual)
- **Enumerated:** December 17, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 012735 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 172 W 21ST ST, Huntington Station, NY 11746-2122
- **Phone:** (631) 209-7883
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Sean Tendler Mental Health Counseling, P.C. (NPI 1437626025, Commack, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 17, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1003575010) · Data from the CMS NPPES public registry.