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MS. LAURIE ANN JACKSON LCSW R
NPI 1104907187
Social Worker - Clinical in Rego Park, NY

Active since October 18, 2006PECOS EnrolledAccepts Medicare Assignment
9745 QUEENS BLVD PH FLOOR, REGO PARK, NY 11374(718) 896-9090(718) 830-0724 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Laurie Ann Jackson Lcsw R NPPES

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

MS. LAURIE ANN JACKSON LCSW R (NPI 1104907187) is an individual clinical provider in Rego Park, New York, licensed in New York (R056949-1) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1104907187
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. LAURIE ANN JACKSONCredential: LCSW R
Location Address9745 QUEENS BLVD PH FLOORRego Park, NY 11374-2101
Mailing Address16832 127th Ave Apt 6Jamaica, NY 11434-3156 · (718) 525-4864
Phone(718) 896-9090
Fax(718) 830-0724
Sole ProprietorYes
Medical School CMSOtherGraduated 1997
Enumeration DateOctober 18, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1104907187 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 NY · R056949-1
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.
9745 QUEENS BLVD PH FLOOR, Rego Park, NY 11374
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Other Identifiers 2

Medicare UPINP19362NY
Medicare ID-Type Unspecified0072UMNY · Medicare Number

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. Laurie Ann Jackson Lcsw R 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 ID6709072754
PECOS Enrollment IDI20101202000303
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11374 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 $67.00 – $201.98
Typical copayment $0.00 (range $16.75 – $50.49)
Most-billed visit code NA
Established Patient
$82.96 typical visit price
range $21.62 – $163.52
Typical copayment $20.74 (range $5.40 – $40.88)
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 Laurie Jackson's NPI number?

The NPI number for Laurie Jackson is 1104907187. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Laurie Jackson located?

Laurie Jackson practices at 9745 Queens Blvd Ph Floor, Rego Park, NY 11374. The listed phone number is (718) 896-9090.

What is Laurie Jackson's specialty?

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

Is Laurie Jackson enrolled in Medicare?

Yes. Laurie 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.

When was this NPI record last updated?

The NPPES record for Laurie Jackson was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.