MRS. SANDRA JACKSON LMHC
NPI 1356330765
Counselor - Mental Health in St Augustine, FL
NPI Status: Active since October 18, 2005
Contact Information
1880 SAN SEBASTIAN VW STE 4201
ST AUGUSTINE, FL
ZIP 32084
Phone: (800) 539-4228
- Individual
- Female
- Counselor
- Mental Health
- Accepts Insurance
- PECOS Enrolled
About SANDRA JACKSON
This page provides the complete NPI Profile along with additional information for Sandra Jackson, a provider established in St Augustine, Florida with a medical specialization in Counselor, focusing in mental health . The healthcare provider is registered in the NPI registry with number 1356330765 assigned on October 2005. The practitioner's primary taxonomy code is 101YM0800X with license number MH8391 (FL). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1356330765
- Provider Name
- MRS. SANDRA JACKSON LMHC
- Other Name
- MS. SANDRA MELCHIONNE LMHC
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1880 SAN SEBASTIAN VW STE 4201 ST AUGUSTINE, FL 32084
- Location Phone
- (800) 539-4228
- Mailing Address
- 150 MAGNOLIA AVE DAYTONA BEACH, FL 32114
- Mailing Phone
- (800) 539-4228
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-18-2005
- Last Update Date
- 10-31-2025
- Code Navigator
A mental health counselor like Sandra Jackson provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Mental Health
- Taxonomy Code
- 101YM0800X
- Type
- Behavioral Health & Social Service Providers
- License No.
- MH8391
- License State
- FL
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | MH8391 (FL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gym Access IND Bronze HMO 1340 - HMO
- Gym Access IND Bronze HMO OA 1211 - HMO
- Gym Access IND Bronze HMO OA Standard 2450 - HMO
- Gym Access IND Bronze POS 1042 - POS
- Gym Access IND Bronze POS BC 3841 - POS
- Gym Access IND Bronze POS OA 1211 - POS
- Gym Access IND Bronze POS OA Standard 2450 - POS
- Gym Access IND Bronze Standardized HMO - HMO
- Gym Access IND Gold HMO 4500 - HMO
- Gym Access IND Gold HMO BC 5651 - HMO
- Gym Access IND Gold HMO H.S.A 9010 - HMO
- Gym Access IND Gold HMO OA Standard 3450 - HMO
- Gym Access IND Gold POS 55001 - POS
- Gym Access IND Gold POS BC 5651 - POS
- Gym Access IND Gold POS OA Standard 3450 - POS
- Gym Access IND Silver HMO BC 0941 - HMO
- Gym Access IND Silver HMO BC 7741 - HMO
- Gym Access IND Silver HMO OA 1009 - HMO
- Gym Access IND Silver HMO OA Standard 1440 - HMO
- Gym Access IND Silver POS BC 0941 - POS
- Molina Bronze Enhanced 3500 - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
- Molina Bronze Standard - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Enhanced 895 - HMO
- Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
- Molina Gold Enhanced 895 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Silver Access - HMO
- Molina Silver Access Plus with Adult Dental and Vision - HMO
- Molina Silver Access Plus with Adult Vision - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 767122900 | MEDICAID (05) | FL | |
| Z089A | OTHER (01) | FL | BCBS |
Medicare Participation & PECOS Enrollment Status
Sandra Jackson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1356330765, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
ST AUGUSTINE, FL 32084
ST AUGUSTINE, FL 32084
ST AUGUSTINE, FL 32084
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356330765, enumerated as an "individual" on October 18, 2005.
The provider is located at 1880 SAN SEBASTIAN VW STE 4201 ST AUGUSTINE, FL 32084 and the phone number is (800) 539-4228.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
The provider might be accepting Accepts: Florida Health Care Plans, Molina Healthcare,. Please consult your insurance carrier or call the provider to verify.
