JACKSON FRIEDRICH RAYNOR MSW, LICSW
NPI 1568152171
Social Worker - Clinical in Saint Paul, MN

Q: What is Jackson Raynor's NPI number?

The NPI number for Jackson Raynor is 1568152171. It was assigned to this individual provider in the NPPES registry on May 9, 2023.

Q: What is Jackson Raynor'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 Jackson Raynor was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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 May 09, 2023PECOS EnrolledAccepts Medicare Assignment

451 LEXINGTON PKWY N, SAINT PAUL, MN 55104(651) 280-2310(651) 280-3995 Get Directions Write a Review

NPPES record last updated: October 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jackson Friedrich Raynor Msw, Licsw NPPES

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

JACKSON FRIEDRICH RAYNOR MSW, LICSW (NPI 1568152171) is an individual clinical provider in Saint Paul, Minnesota, licensed in Minnesota (31487) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1568152171

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameJACKSON FRIEDRICH RAYNORCredential: MSW, LICSW

Location Address451 LEXINGTON PKWY NSaint Paul, MN 55104-4636

Mailing Address451 Lexington Pkwy NSaint Paul, MN 55104-4636 · (651) 280-2310 · Fax (651) 280-3995

Phone(651) 280-2310

Fax(651) 280-3995

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateMay 9, 2023

Last NPPES UpdateOctober 31, 2025

NPPES CertifiedOctober 31, 2025

✔ NPI 1568152171 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 · 31487

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.

451 LEXINGTON PKWY N, Saint Paul, MN 55104

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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 and accepts Medicare assignment

Jackson Friedrich Raynor Msw, 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 ID8527459155

PECOS Enrollment IDI20251113000634

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 55104 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.

PANG XIONG

Counselor (Professional)