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

Q: 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.

Q: What is David Jackson's specialty?

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

Q: 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.

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: August 16, 2026.

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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, and ordering and referring status from the CMS PECOS system.

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.

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.

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