MS. KASSANDRA LYNN JACKSON LMSW
NPI 1083960942
Social Worker in Livonia, MI
About Ms. Kassandra Lynn Jackson Lmsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. KASSANDRA LYNN JACKSON LMSW (NPI 1083960942) is an individual social worker in Livonia, Michigan, licensed in Michigan (6801093643) and active in the NPI registry since July 2012. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 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 (PECOS)
Ms. Kassandra Lynn Jackson Lmsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kassandra Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Plymouth, MI 48170
- Reassigned Medicare billing, Michigan enrollment
- 27 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LIVONIA, MI 48152
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 Kassandra Jackson's NPI number?
The NPI number for Kassandra Jackson is 1083960942. It was assigned to this individual provider in the NPPES registry on July 30, 2012.
Where is Kassandra Jackson located?
Kassandra Jackson practices at 17940 Farmington Rd, Livonia, MI 48152. The listed phone number is (517) 234-3627.
What is Kassandra Jackson's specialty?
The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.
Is Kassandra Jackson enrolled in Medicare?
Yes. Kassandra Jackson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kassandra Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kassandra Jackson reassigns Medicare benefits to Simply Mindful Counseling, LLC (Plymouth, MI). 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 Kassandra Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kassandra Jackson accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and Priority Health list Kassandra 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 Kassandra Jackson was last updated on June 10, 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.
# Ms. Kassandra Lynn Jackson, LMSW · NPI 1083960942
Social Worker provider in Livonia, Michigan. Individual provider, active in the CMS NPPES registry since July 30, 2012.
## Identity
- **NPI:** 1083960942 (Entity type: Individual)
- **Enumerated:** July 30, 2012
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **State license:** 6801093643 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 17940 FARMINGTON RD, Livonia, MI 48152-4444
- **Phone:** (517) 234-3627
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Simply Mindful Counseling, LLC (NPI 1851900302, Plymouth, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 10, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1083960942) · Data from the CMS NPPES public registry.