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JACKSON MENTAL HEALTH SERVICES, LLC
NPI 1144196940
Nurse Practitioner - Psychiatric/Mental Health in Hermanville, MS

Active since October 17, 2025
1035 COURTNEY RD, HERMANVILLE, MS 39086(601) 448-9924(601) 202-4010 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 22, 2026, Apr 29, 2026, Dec 24, 2025 (3 updates tracked since 2025).

About Jackson Mental Health Services, Llc NPPES

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

JACKSON MENTAL HEALTH SERVICES, LLC (NPI 1144196940) is a healthcare organization registered as a psychiatric/mental health in Hermanville, Mississippi and active in the NPI registry since October 2025. The organization lists Dominique Alexis Jackson, Owner, as its authorized official.

NPPES Registry Identity

NPI1144196940
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameJACKSON MENTAL HEALTH SERVICES, LLC
Location Address1035 COURTNEY RDHermanville, MS 39086-7700
Mailing Address1035 Courtney RdHermanville, MS 39086-7700 · (601) 589-4854 · Fax (601) 893-7096
Phone(601) 448-9924
Fax(601) 202-4010
Organization SubpartNo
Authorized OfficialDominique Alexis JacksonOwner · (601) 589-4854
Enumeration DateOctober 17, 2025
Last NPPES UpdateJuly 22, 20263 updates tracked since enumeration
NPPES CertifiedJuly 22, 2026
✔ NPI 1144196940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
1035 COURTNEY RD, Hermanville, MS 39086
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Mental Health Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jackson Mental Health Services, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dominique Jackson, PMHNP-C
Nurse Practitioner
NPI 1487487864
604 HIGHWAY 80 W STE P-1
Clinton, MS 39056
(601) 589-4854
✔ PECOS✔ Accepts Medicare41 mi

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

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 Jackson Mental Health Services, LLC's NPI number?

The NPI number for Jackson Mental Health Services, LLC is 1144196940. It was assigned to this organization in the NPPES registry on October 17, 2025.

Where is Jackson Mental Health Services, LLC located?

Jackson Mental Health Services, LLC is located at 1035 Courtney Rd, Hermanville, MS 39086. The listed phone number is (601) 448-9924.

What is Jackson Mental Health Services, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jackson Mental Health Services, LLC enrolled in Medicare?

Yes. Jackson Mental Health Services, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jackson Mental Health Services, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Jackson Mental Health Services, LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Jackson Mental Health Services, LLC accept?

Health plans from Molina Healthcare list Jackson Mental Health Services, LLC 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 Jackson Mental Health Services, LLC was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.