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DAMARIA EMAUNE JACKSON LPC
NPI 1194224923
Counselor - Mental Health in Dayton, OH

Active since February 07, 2018PECOS Enrolled
10861 YANKEE ST, DAYTON, OH 45458(937) 619-0800 Get Directions Write a Review

NPPES record last updated: December 9, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Damaria Emaune Jackson Lpc NPPES

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

DAMARIA EMAUNE JACKSON LPC (NPI 1194224923) is an individual mental health provider in Dayton, Ohio, licensed in Ohio (2204717) and active in the NPI registry since February 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194224923
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDAMARIA EMAUNE JACKSONCredential: LPC
Location Address10861 YANKEE STDayton, OH 45458-3574
Mailing Address1522 N Main St Apt ADayton, OH 45405-4152
Phone(937) 619-0800
Sole ProprietorNo
Enumeration DateFebruary 7, 2018
Last NPPES UpdateDecember 9, 2022
NPPES CertifiedDecember 9, 2022
✔ NPI 1194224923 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 OH · 2204717
10861 YANKEE ST, Dayton, OH 45458
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual 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 (PECOS)

Damaria Emaune Jackson Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Damaria Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mindfully, LLC
25 mi
Counselor
1251 NILLES RD STE 5
Fairfield, OH 45014
  • Reassigned Medicare billing, Ohio enrollment
  • 134 clinicians in this Medicare group
NPI 1972702520 (513) 939-0300

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

Other Providers at the Same Location NPPES 14

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

SASHA N BONGORNO LPC
Counselor (Mental Health)
10861 YANKEE ST
CENTERVILLE, OH 45458
Montgomery County (216) 212-5856
ERICKA L MACHUCA LSW
Social Worker
10861 YANKEE ST
CENTERVILLE, OH 45458
Montgomery County (937) 619-0800
ERICA GAD CT
Counselor (Professional)
10861 YANKEE ST
CENTERVILLE, OH 45458
Montgomery County (937) 619-0800
TAMEKA SHANTAE GIBBS
Counselor (Mental Health)
10861 YANKEE ST
CENTERVILLE, OH 45458
Montgomery County (888) 830-0347
ABIGAIL STOCKSDALE CT
Counselor (Mental Health)
10861 YANKEE ST
CENTERVILLE, OH 45458
Montgomery County (937) 619-0800
ASHLEE J FERRELL SWT
Social Worker
10861 YANKEE ST
CENTERVILLE, OH 45458
Montgomery County (937) 619-0800
KENDRA WELLS SWT
Social Worker (Clinical)
10861 YANKEE ST
CENTERVILLE, OH 45458
Montgomery County (937) 619-0800
KAYLA ANN PENNIE LSW
Social Worker (Clinical)
10861 YANKEE ST
CENTERVILLE, OH 45458
Montgomery County (937) 619-0800

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 Damaria Jackson's NPI number?

The NPI number for Damaria Jackson is 1194224923. It was assigned to this individual provider in the NPPES registry on February 7, 2018.

Where is Damaria Jackson located?

Damaria Jackson practices at 10861 Yankee St, Dayton, OH 45458. The listed phone number is (937) 619-0800.

What is Damaria Jackson's specialty?

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

Is Damaria Jackson enrolled in Medicare?

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

Which organization bills Medicare for Damaria Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Damaria Jackson reassigns Medicare benefits to Mindfully, LLC (Fairfield, OH). 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 Damaria Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Damaria Jackson accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance and 1 other insurer list Damaria 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 Damaria Jackson was last updated on December 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.