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DAVID JACKSON LICSW
NPI 1548972425
Social Worker - Clinical in Pine City, MN

Active since December 22, 2022PECOS EnrolledAccepts Medicare Assignment
220 RAILROAD ST SE, PINE CITY, MN 55063(320) 629-7600 Get Directions Write a Review

NPPES record last updated: December 22, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About David Jackson Licsw NPPES

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

DAVID JACKSON LICSW (NPI 1548972425) is an individual clinical provider in Pine City, Minnesota, licensed in Minnesota (21551) and active in the NPI registry since December 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1548972425
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameDAVID JACKSONCredential: LICSW
Location Address220 RAILROAD ST SEPine City, MN 55063-1540
Mailing Address220 Railroad St SePine City, MN 55063-1540 · (320) 629-7600
Phone(320) 629-7600
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateDecember 22, 2022
NPPES CertifiedDecember 22, 2022
✔ NPI 1548972425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 21551
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.
220 RAILROAD ST SE, Pine City, MN 55063
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Other Identifiers 1

Medicaid21551MN

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

David Jackson Licsw 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 ID4385001361
PECOS Enrollment IDI20230606003501
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.

Medicare Billing Reassignment

Medicare enrollment records show David Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Therapeutic Services Agency Inc
Same address
Marriage & Family Therapist
220 RAILROAD ST SE
Pine City, MN 55063
  • Reassigned Medicare billing, Minnesota enrollment
  • 20 clinicians in this Medicare group
NPI 1497741607 (320) 629-7600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55063 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.

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.

NATHAN D VOJTECH LMFT
Marriage & Family Therapist
220 RAILROAD ST SE
PINE CITY, MN 55063
Pine County (320) 629-7600
MRS. CHRISTINE TANDE JOHNSON PSYD LP
Psychologist
220 RAILROAD ST SE
PINE CITY, MN 55063
Pine County (320) 629-7600
JANICE REICH LMFT
Marriage & Family Therapist
220 RAILROAD ST SE
PINE CITY, MN 55063
Pine County (320) 629-7600
MARY ALICE ROSE MCHUGH MSW, LICSW
Social Worker
220 RAILROAD ST SE
PINE CITY, MN 55063
Pine County (320) 629-7600
BETHANY RENEE CLEARY MA, LPCC
Counselor (Professional)
220 RAILROAD ST SE
PINE CITY, MN 55063
Pine County (320) 629-7600
MRS. KELLY ANN BUCHTA MSW, LICSW
Social Worker (Clinical)
220 RAILROAD ST SE
PINE CITY, MN 55063
Pine County (320) 629-7600
BETHANY ALMOS
Social Worker (Clinical)
220 RAILROAD ST SE
PINE CITY, MN 55063
Pine County (320) 629-7600
NICOLE CECELIA HUBBS LMFT
Counselor (Mental Health)
220 RAILROAD ST SE
PINE CITY, MN 55063
Pine County (320) 629-7600

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 David Jackson's NPI number?

The NPI number for David Jackson is 1548972425. It was assigned to this individual provider in the NPPES registry on December 22, 2022.

Where is David Jackson located?

David Jackson practices at 220 Railroad St SE, Pine City, MN 55063. The listed phone number is (320) 629-7600.

What is David Jackson's specialty?

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

Is David Jackson enrolled in Medicare?

Yes. David 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.

Which organization bills Medicare for David Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Jackson reassigns Medicare benefits to Therapeutic Services Agency Inc (Pine City, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for David Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does David Jackson accept?

Health plans from HealthPartners list David 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 David Jackson was last updated on December 22, 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.