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KELSEE B JACKSON
NPI 1104619659
Social Worker - Clinical in Rio Grande, NJ

Active since May 27, 2025PECOS Enrolled
1127 NJ-47, STE 9, RIO GRANDE, NJ 08242(856) 839-5678 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kelsee B Jackson NPPES

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

KELSEE B JACKSON (NPI 1104619659) is an individual clinical provider in Rio Grande, New Jersey, licensed in New Jersey (44SL06898900) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1104619659
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELSEE B JACKSON
Location Address1127 NJ-47, STE 9Rio Grande, NJ 08242
Mailing AddressPo Box 4Buena, NJ 08310-0004 · (856) 839-5678
Phone(856) 839-5678
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 27, 2025
NPPES CertifiedMay 14, 2025
✔ NPI 1104619659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NJ · 44SL06898900
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1127 NJ-47, Rio Grande, NJ 08242
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelsee B Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6901377027
PECOS Enrollment IDI20260609002176
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 Kelsee Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group Of New Jersey PC
127 mi
Mental Health
221 RIVER ST. FL 9
Hoboken, NJ 07030
  • Reassigned Medicare billing, New Jersey enrollment
  • 673 clinicians in this Medicare group
NPI 1841949328 (201) 439-8902

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 08242 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
$0.00 typical visit price
range $61.59 – $185.05
Typical copayment $0.00 (range $15.39 – $46.26)
Most-billed visit code NA
Established Patient
$76.45 typical visit price
range $20.08 – $150.98
Typical copayment $19.11 (range $5.02 – $37.74)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kelsee Jackson's NPI number?

The NPI number for Kelsee Jackson is 1104619659. It was assigned to this individual provider in the NPPES registry on May 27, 2025.

Where is Kelsee Jackson located?

Kelsee Jackson practices at 1127 Nj-47 Ste 9, Rio Grande, NJ 08242. The listed phone number is (856) 839-5678.

What is Kelsee Jackson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kelsee Jackson enrolled in Medicare?

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

Which organization bills Medicare for Kelsee Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelsee Jackson reassigns Medicare benefits to Grow Healthcare Group Of New Jersey PC (Hoboken, NJ). 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 Kelsee 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 Kelsee Jackson was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.