IRENE DORMENIE JACKSON LCMHC, LCAS-A
NPI 1053927723
Counselor - Mental Health in Durham, NC

Active since September 18, 2020PECOS EnrolledAccepts Medicare Assignment
904 WOODGREEN DR, DURHAM, NC 27704(919) 641-8358 Get Directions Write a Review

NPPES record last updated: October 24, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1053927723
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameIRENE DORMENIE JACKSONCredential: LCMHC, LCAS-A
Location Address904 WOODGREEN DRDurham, NC 27704-6034
Mailing Address904 Woodgreen DrDurham, NC 27704-6034 · (919) 641-8358
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateSeptember 18, 2020
Last NPPES UpdateOctober 24, 2024
NPPES CertifiedOctober 24, 2024
NPI 1053927723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in NC · 16165
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LCAS-26084 (NC)
904 WOODGREEN DR, Durham, NC 27704

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 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.

PECOS PAC ID6901332592
PECOS Enrollment IDI20241205002986
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.

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.

What insurance does Irene Jackson accept?

Health plans from Blue Cross and Blue Shield of NC 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 21 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.