MS. MAIA SHANAE JACKSON LICSW
NPI 1194311043
Social Worker - Clinical in Minneapolis, MN

Q: What is Maia Jackson's NPI number?

The NPI number for Maia Jackson is 1194311043. It was assigned to this individual provider in the NPPES registry on December 15, 2020.

Q: What is Maia Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Maia Jackson was last updated on October 13, 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.

Active since December 15, 2020PECOS Enrolled

1100 GLENWOOD AVE, MINNEAPOLIS, MN 55405(612) 871-1454(612) 871-1505 Get Directions Write a Review

NPPES record last updated: October 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 13, 2022, Dec 15, 2020 (2 updates tracked since 2020).

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About Ms. Maia Shanae Jackson Licsw NPPES

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

MS. MAIA SHANAE JACKSON LICSW (NPI 1194311043) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (29112) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194311043

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMS. MAIA SHANAE JACKSONCredential: LICSW

Location Address1100 GLENWOOD AVEMinneapolis, MN 55405-1430

Mailing Address1100 Glenwood AveMinneapolis, MN 55405-1430 · (612) 871-1454 · Fax (612) 871-1505

Phone(612) 871-1454

Fax(612) 871-1505

Sole ProprietorNo

Enumeration DateDecember 15, 2020

Last NPPES UpdateOctober 13, 20222 updates tracked since enumeration

NPPES CertifiedDecember 15, 2020

✔ NPI 1194311043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in MN · 29112

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.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

1100 GLENWOOD AVE, Minneapolis, MN 55405

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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Maia Shanae Jackson Licsw 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55405 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 $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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.

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Other Providers at the Same Location NPPES 20

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

SYDNEY BARTZ MSW, LICSW

Social Worker (Clinical)