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LATESHIA JACKSON
NPI 1063840262
Nurse Practitioner - Psychiatric/Mental Health in Easton, MD

Active since October 24, 2013PECOS Enrolled
8737 BROOKS DR STE 108, EASTON, MD 21601(800) 867-2395(410) 443-4960 Get Directions Write a Review

NPPES record last updated: September 18, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 18, 2019, Sep 11, 2019, Sep 4, 2018 (3 updates tracked since 2018).

About Lateshia Jackson NPPES

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

LATESHIA JACKSON (NPI 1063840262) is an individual psychiatric/mental health provider in Easton, Maryland, licensed in Maryland (R193593) and active in the NPI registry since October 2013. She is enrolled in Medicare PECOS and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1063840262
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameLATESHIA JACKSON
Location Address8737 BROOKS DR STE 108Easton, MD 21601-7474
Mailing Address8142 Harold CtGlen Burnie, MD 21061-4960 · (202) 253-3588
Phone(800) 867-2395
Fax(410) 443-4960
Sole ProprietorNo
Enumeration DateOctober 24, 2013
Last NPPES UpdateSeptember 18, 20193 updates tracked since enumeration
✔ NPI 1063840262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MD · R193593
8737 BROOKS DR STE 108, Easton, MD 21601
Open in Google Maps ↗

Secondary Practice Locations 5

Location 1505 E Main StSalisbury, MD 21804-5020 · Phone (410) 341-3420
Location 28142 Harold CtGlen Burnie, MD 21061 · Phone (202) 253-3588
Location 32324 West Zion Road Suite 112, Suite 112Salisbury, MD 21801 · Phone (800) 867-2395 · Fax (410) 443-0842
Location 4514 Poplar StCambridge, MD 21613-1834 · Phone (800) 867-2395 · Fax (410) 443-0842
Location 5200 Booth StElkton, MD 21921-5657 · Phone (410) 996-3400

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lateshia Jackson 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Lateshia Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Arundel Lodge, Inc
25 mi
Community/Behavioral Health
1819 BAY RIDGE AVE STE 220
Annapolis, MD 21403
  • Reassigned Medicare billing, Maryland enrollment
  • 27 clinicians in this Medicare group
NPI 1689063059 (443) 433-5900
Upper Bay Counseling And Support Services, Inc
52 mi
Mental Health (Including Community Mental Health Center)
626 REVOLUTION ST
Havre De Grace, MD 21078
  • Reassigned Medicare billing, Maryland enrollment
  • Medicare enrollment name: Upper Bay Counseling & Support Services, Inc.
  • 30 clinicians in this Medicare group
NPI 1114252020 (410) 939-8744

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.75 typical visit price
range $57.99 – $175.57
Typical copayment $22.43 (range $14.49 – $43.89)
Most-billed visit code 99203
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

MAKENZIE COWGER
Counselor (Addiction (Substance Use Disorder))
8737 BROOKS DR STE 108
EASTON, MD 21601
Talbot County (800) 867-2395
KATHRYN C NORMAN ADT
Counselor (Addiction (Substance Use Disorder))
8737 BROOKS DR STE 108
EASTON, MD 21601
Talbot County (800) 867-2395
DAPHIME JACKSON CSC-AD
Counselor (Addiction (Substance Use Disorder))
8737 BROOKS DR STE 108
EASTON, MD 21601
Talbot County (800) 867-2395
ANDREA DIXON
Social Worker (Clinical)
8737 BROOKS DR STE 108
EASTON, MD 21601
Talbot County (800) 867-2395
ANDREA MARIA KELLEY-FREEMAN M.S.
Counselor (Addiction (Substance Use Disorder))
8737 BROOKS DR STE 108
EASTON, MD 21601
Talbot County (410) 818-5649
MRS. JESSICA HART BASS LCPC, LCPAT, ATR-BC
Counselor (Professional)
8737 BROOKS DR STE 108
EASTON, MD 21601
Talbot County (800) 867-2395
NICOLE MORRIS ADT
Counselor (Addiction (Substance Use Disorder))
8737 BROOKS DR STE 108
EASTON, MD 21601
Talbot County (800) 867-2395
LIFES ENERGY WELLNESS CENTER INC.
Counselor (Addiction (Substance Use Disorder))
8737 BROOKS DR STE 108, SUITE 108
EASTON, MD 21601
Talbot County (800) 867-2395

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 Lateshia Jackson's NPI number?

The NPI number for Lateshia Jackson is 1063840262. It was assigned to this individual provider in the NPPES registry on October 24, 2013.

Where is Lateshia Jackson located?

Lateshia Jackson practices at 8737 Brooks Dr Ste 108, Easton, MD 21601. The listed phone number is (800) 867-2395.

What is Lateshia Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Lateshia Jackson enrolled in Medicare?

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

Which organizations bill Medicare for Lateshia Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lateshia Jackson reassigns Medicare benefits to 2 organizations: Arundel Lodge, Inc (Annapolis, MD) and Upper Bay Counseling And Support Services, Inc (Havre De Grace, MD). Each 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 Lateshia Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lateshia Jackson was last updated on September 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.