IRENE DORMENIE JACKSON LCMHC, LCAS-A
NPI 1053927723
Counselor - Mental Health in Durham, NC
About Irene Dormenie Jackson Lcmhc, Lcas-a NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IRENE DORMENIE JACKSON LCMHC, LCAS-A (NPI 1053927723) is an individual mental health provider in Durham, North Carolina, licensed in North Carolina (16165) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Irene Dormenie Jackson Lcmhc, Lcas-a is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Irene Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mooresville, NC 28117
- Reassigned Medicare billing, North Carolina enrollment
- 197 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.
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 Irene Jackson's NPI number?
The NPI number for Irene Jackson is 1053927723. It was assigned to this individual provider in the NPPES registry on September 18, 2020.
Where is Irene Jackson located?
Irene Jackson practices at 904 Woodgreen Dr, Durham, NC 27704. The listed phone number is (919) 641-8358.
What is Irene Jackson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Irene Jackson enrolled in Medicare?
Yes. Irene Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Irene Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Irene Jackson reassigns Medicare benefits to Integrative Wellness Solutions, PLLC (Mooresville, NC). 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 Irene Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Irene Jackson accept?
Health plans from Cigna Healthcare and UnitedHealthcare list Irene 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 Irene Jackson was last updated on October 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Irene Dormenie Jackson, LCMHC, LCAS-A · NPI 1053927723
Mental Health provider in Durham, North Carolina. Individual provider, active in the CMS NPPES registry since September 18, 2020.
## Identity
- **NPI:** 1053927723 (Entity type: Individual)
- **Enumerated:** September 18, 2020
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 16165 (North Carolina)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 904 WOODGREEN DR, Durham, NC 27704-6034
- **Phone:** (919) 641-8358
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Integrative Wellness Solutions, PLLC (NPI 1447760871, Mooresville, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** October 24, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1053927723) · Data from the CMS NPPES public registry.