JOANN MICHELLE JACKSON PSY.D.
NPI 1194739904
Psychologist in South Bend, IN

Active since July 28, 2006PECOS EnrolledAccepts Medicare Assignment
403 E MADISON ST, SOUTH BEND, IN 46617(574) 533-1234(574) 537-2652 Get Directions Write a Review

NPPES record last updated: September 27, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Joann Michelle Jackson Psy.d. NPPES

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

JOANN MICHELLE JACKSON PSY.D. (NPI 1194739904) is an individual psychologist in South Bend, Indiana, licensed in Indiana (20040982A) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1993).

NPPES Registry Identity

NPI1194739904
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameJOANN MICHELLE JACKSONCredential: PSY.D.
Location Address403 E MADISON STSouth Bend, IN 46617-2322
Mailing Address330 Lakeview DrGoshen, IN 46528-9365 · (574) 533-1234 · Fax (574) 537-2652
Fax(574) 537-2652
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateJuly 28, 2006
Last NPPES UpdateSeptember 27, 2010
NPI 1194739904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IN · 20040982A
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
403 E MADISON ST, South Bend, IN 46617

Other Identifiers 3

Medicare UPINS19171
Medicaid200200700AIN
Medicare ID-Type Unspecified237590FIN

Accepted Insurance

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

Joann Michelle Jackson Psy.d. 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 ID2668652173
PECOS Enrollment IDI20150513001859
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.

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.

Social Worker
403 E MADISON ST
SOUTH BEND, IN 46617
Social Worker (Clinical)
403 E MADISON ST
SOUTH BEND, IN 46617
Counselor
403 E MADISON ST
SOUTH BEND, IN 46617
Social Worker (Clinical)
403 E MADISON ST
SOUTH BEND, IN 46617
Psychologist (Clinical Child & Adolescent)
403 E MADISON ST
SOUTH BEND, IN 46617
Social Worker (Clinical)
403 E MADISON ST
SOUTH BEND, IN 46617
Counselor
403 E MADISON ST
SOUTH BEND, IN 46617
Social Worker (Clinical)
403 E MADISON ST
SOUTH BEND, IN 46617

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 Joann Jackson's NPI number?

The NPI number for Joann Jackson is 1194739904. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Joann Jackson located?

Joann Jackson practices at 403 E Madison St, South Bend, IN 46617. The listed phone number is (574) 533-1234.

What is Joann Jackson's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Joann Jackson enrolled in Medicare?

Yes. Joann 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.

What insurance does Joann Jackson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Joann 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 Joann Jackson was last updated on September 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.