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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: October 25, 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
Phone(941) 625-5895
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
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Other Identifiers 1

Medicaid116480500FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Cigna Healthcare and more.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

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.

Medicare Billing Reassignment

Medicare enrollment records show Candis Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bennett W Mcallister MD PA
Same address
Mental Health (Including Community Mental Health Center)
4161 TAMIAMI TRL STE 304D
Port Charlotte, FL 33952
  • Reassigned Medicare billing, Florida enrollment
  • 8 clinicians in this Medicare group
NPI 1104154053 (941) 625-5895

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

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.

BENNETT W MCALLISTER MD PA
Clinic/Center (Mental Health (Including Community Mental Health Center))
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Charlotte County (941) 625-5895
DR. BENNETT WILLIAM MCALLISTER MD
Psychiatry & Neurology (Psychiatry)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Charlotte County (941) 625-5895
BELINDA ALMA LMHC
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Charlotte County (941) 625-5895
CHARMAINE ROSEMARIE WOLFE LMHC
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Charlotte County (416) 255-8959
HEDRICK FRANK LMHC
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Charlotte County (941) 625-5895
MS. RANDY M CISNE LMHC
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Charlotte County (941) 625-5895
CHEMENDA SAWYER LMHC
Counselor (Mental Health)
4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL 33952
Charlotte County (941) 625-5895

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.

Which organization bills Medicare for Candis Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Candis Jackson reassigns Medicare benefits to Bennett W Mcallister MD PA (Port Charlotte, FL). 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 Candis Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Candis Jackson accept?

Health plans from Ambetter Health, Ambetter of Alabama, Cigna HealthCare of Florida, Inc., Cigna Healthcare and Florida Blue (BlueCross BlueShield FL) and 3 other insurers 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.