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SAMANTHA J JACKSON LICSW
NPI 1265108484
Social Worker - Clinical in Salem, OR

Active since August 18, 2021PECOS Enrolled
2355 STATE ST STE 10, SALEM, OR 97301(541) 577-1657 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 8, 2024, Dec 4, 2023, Mar 10, 2023 and 2 more (5 updates tracked since 2021).

About Samantha J Jackson Licsw NPPES

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

SAMANTHA J JACKSON LICSW (NPI 1265108484) is an individual clinical provider in Salem, Oregon, licensed in Minnesota (25126) and active in the NPI registry since August 2021. The provider is enrolled in Medicare PECOS and maintains a secondary practice location in Owatonna.

NPPES Registry Identity

NPI1265108484
Entity TypeIndividual
Primary Taxonomy1041C0700X
Provider Legal NameSAMANTHA J JACKSONCredential: LICSW
Location Address2355 STATE ST STE 10Salem, OR 97301-4541
Mailing Address2355 State St Ste 10Salem, OR 97301-4541 · (541) 577-1657
Phone(541) 577-1657
Sole ProprietorYes
Enumeration DateAugust 18, 2021
Last NPPES UpdateMay 8, 20245 updates tracked since enumeration
NPPES CertifiedMay 8, 2024
✔ NPI 1265108484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in MN · 25126✔ Licensed in OR · L14321
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.
2355 STATE ST STE 10, Salem, OR 97301
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Secondary Practice Location 1

Location 1202 N Cedar Ave Ste 1Owatonna, MN 55060-2306 · Phone (541) 577-6571

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.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)

Samantha J 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 97301 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 $54.96 – $166.64
Typical copayment $0.00 (range $13.74 – $41.66)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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 Samantha Jackson's NPI number?

The NPI number for Samantha Jackson is 1265108484. It was assigned to this individual provider in the NPPES registry on August 18, 2021.

Where is Samantha Jackson located?

Samantha Jackson practices at 2355 State St Ste 10, Salem, OR 97301. The listed phone number is (541) 577-1657.

What is Samantha Jackson's specialty?

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

Is Samantha Jackson enrolled in Medicare?

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

What insurance does Samantha Jackson accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Samantha 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 Samantha Jackson was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.