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MR. RICHARD ALLEN JACKSON LICSW
NPI 1629520770
Social Worker - Clinical in Brainerd, MN

Active since October 25, 2016PECOS EnrolledAccepts Medicare Assignment
201 W LAUREL ST, BRAINERD, MN 56401(218) 454-3844(218) 454-3844 Get Directions Write a Review

NPPES record last updated: April 12, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 12, 2018, Oct 25, 2016 (2 updates tracked since 2016).

About Mr. Richard Allen Jackson Licsw NPPES

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

MR. RICHARD ALLEN JACKSON LICSW (NPI 1629520770) is an individual clinical provider in Brainerd, Minnesota, licensed in Minnesota (23282) and active in the NPI registry since October 2016. He is enrolled in Medicare PECOS, maintains a secondary practice location in Brainerd, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1629520770
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. RICHARD ALLEN JACKSONCredential: LICSW
Location Address201 W LAUREL STBrainerd, MN 56401-3902
Mailing Address823 Maple StBrainerd, MN 56401-3770
Phone(218) 454-3844
Fax(218) 454-3844
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 25, 2016
Last NPPES UpdateApril 12, 20182 updates tracked since enumeration
✔ NPI 1629520770 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 · 23282
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.
201 W LAUREL ST, Brainerd, MN 56401
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Secondary Practice Location 1

Location 1201 W Laurel StBrainerd, MN 56401-3902 · Phone (218) 454-3844 · Fax (218) 454-3844

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

Mr. Richard Allen 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 ID749567451
PECOS Enrollment IDI20170508000243
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 56401 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

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE ANN RIEKE MSW, LICSW
Social Worker (Clinical)
201 W LAUREL ST
BRAINERD, MN 56401
Crow Wing County (218) 454-3845

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 Richard Jackson's NPI number?

The NPI number for Richard Jackson is 1629520770. It was assigned to this individual provider in the NPPES registry on October 25, 2016.

Where is Richard Jackson located?

Richard Jackson practices at 201 W Laurel St, Brainerd, MN 56401. The listed phone number is (218) 454-3844.

What is Richard Jackson's specialty?

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

Is Richard Jackson enrolled in Medicare?

Yes. Richard 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.

When was this NPI record last updated?

The NPPES record for Richard Jackson was last updated on April 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.