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TIFFANY JACKSON LMSW
NPI 1316532591
Counselor - Professional in East Point, GA

Active since March 09, 2021PECOS Enrolled
2474 BLACK FOX TRL, EAST POINT, GA 30344(510) 435-2172 Get Directions Write a Review

NPPES record last updated: March 9, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tiffany Jackson Lmsw NPPES

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

TIFFANY JACKSON LMSW (NPI 1316532591) is an individual professional provider in East Point, Georgia and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1316532591
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameTIFFANY JACKSONCredential: LMSW
Location Address2474 BLACK FOX TRLEast Point, GA 30344-6612
Mailing Address2474 Black Fox TrlEast Point, GA 30344-6612 · (510) 435-2172
Phone(510) 435-2172
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateMarch 9, 2021
NPPES CertifiedMarch 9, 2021
✔ NPI 1316532591 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
2474 BLACK FOX TRL, East Point, GA 30344
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tiffany Jackson Lmsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5597234435
PECOS Enrollment IDI20260520001167
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.

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 Tiffany Jackson's NPI number?

The NPI number for Tiffany Jackson is 1316532591. It was assigned to this individual provider in the NPPES registry on March 9, 2021.

Where is Tiffany Jackson located?

Tiffany Jackson practices at 2474 Black Fox Trl, East Point, GA 30344. The listed phone number is (510) 435-2172.

What is Tiffany Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Tiffany Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Tiffany Jackson was last updated on March 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.