MS. CANDIS L JACKSON LMHC
NPI 1104004746
Counselor - Mental Health in Port Charlotte, FL

Active since February 06, 2008PECOS EnrolledAccepts Medicare Assignment
4161 TAMIAMI TRL STE 304D, PORT CHARLOTTE, FL 33952(941) 625-5895(941) 625-1047 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Candis L Jackson Lmhc NPPES

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

MS. CANDIS L JACKSON LMHC (NPI 1104004746) is an individual mental health provider in Port Charlotte, Florida, licensed in Florida (MH4441) and active in the NPI registry since February 2008. She is enrolled in Medicare PECOS and is a graduate of Other (1972).

NPPES Registry Identity

NPI1104004746
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. CANDIS L JACKSONCredential: LMHC
Location Address4161 TAMIAMI TRL STE 304DPort Charlotte, FL 33952-9254
Mailing AddressPo Box 512139Punta Gorda, FL 33951-2139 · (941) 625-5895 · Fax (941) 625-1047
Fax(941) 625-1047
Sole ProprietorNo
Medical School CMSOtherGraduated 1972
Enumeration DateFebruary 6, 2008
Last NPPES UpdateMay 7, 2024
NPPES CertifiedMay 7, 2024
NPI 1104004746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in FL · MH4441
4161 TAMIAMI TRL STE 304D, Port Charlotte, FL 33952

Other Identifiers 1

Medicaid116480500FL

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

Ms. Candis L Jackson Lmhc 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 ID2668814625
PECOS Enrollment IDI20240522004291
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
38 services13 patients

Other Providers at the Same Location NPPES 7

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

Clinic/Center (Mental Health (Including Community Mental Health Center))
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Psychiatry & Neurology (Psychiatry)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952

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 Candis Jackson's NPI number?

The NPI number for Candis Jackson is 1104004746. It was assigned to this individual provider in the NPPES registry on February 6, 2008.

Where is Candis Jackson located?

Candis Jackson practices at 4161 Tamiami Trl Ste 304D, Port Charlotte, FL 33952. The listed phone number is (941) 625-5895.

What is Candis Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Candis Jackson enrolled in Medicare?

Yes. Candis 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 Candis Jackson accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida and 1 other insurer list Candis 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 Candis Jackson was last updated on May 7, 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.