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SKYLETTE V JACKSON LCPC (MD), LPC (VA)
NPI 1639667611
Counselor - Mental Health in Princess Anne, MD

Active since April 25, 2018PECOS Enrolled
12302 SOMERSET AVE STE D, PRINCESS ANNE, MD 21853(443) 614-0829 Get Directions Write a Review

NPPES record last updated: April 24, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 24, 2026, Apr 25, 2018 (2 updates tracked since 2018).

About Skylette V Jackson Lcpc (md), Lpc (va) NPPES

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

SKYLETTE V JACKSON LCPC (MD), LPC (VA) (NPI 1639667611) is an individual mental health provider in Princess Anne, Maryland, licensed in Maryland (LC17807) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1639667611
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSKYLETTE V JACKSONCredential: LCPC (MD), LPC (VA)
Location Address12302 SOMERSET AVE STE DPrincess Anne, MD 21853-3099
Mailing Address12302 Somerset AvePrincess Anne, MD 21853-3099 · (443) 614-0829
Phone(443) 614-0829
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 25, 2018
Last NPPES UpdateApril 24, 20262 updates tracked since enumeration
NPPES CertifiedApril 24, 2026
✔ NPI 1639667611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Licenses✔ Licensed in MD · LC17807✔ Licensed in VA · 0701015474
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 1718 (DE)
12302 SOMERSET AVE STE D, Princess Anne, MD 21853
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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 (PECOS)

Skylette V Jackson Lcpc (md), Lpc (va) is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072077643
PECOS Enrollment IDI20260714004992
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.

Other Providers at the Same Location NPPES 3

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

NEXT CHAPTER BEHAVIORAL HEALTH LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
12302 SOMERSET AVE STE D
PRINCESS ANNE, MD 21853
Somerset County (443) 888-0565
NEXT CHAPTER BEHAVIORAL HEALTH LLC
Counselor (Addiction (Substance Use Disorder))
12302 SOMERSET AVE STE D
PRINCESS ANNE, MD 21853
Somerset County (443) 888-0565
NEXT CHAPTER BEHAVIORAL HEALTH LLC
Counselor (Addiction (Substance Use Disorder))
12302 SOMERSET AVE STE D
PRINCESS ANNE, MD 21853
Somerset County (443) 736-7721

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 Skylette Jackson's NPI number?

The NPI number for Skylette Jackson is 1639667611. It was assigned to this individual provider in the NPPES registry on April 25, 2018.

Where is Skylette Jackson located?

Skylette Jackson practices at 12302 Somerset Ave Ste D, Princess Anne, MD 21853. The listed phone number is (443) 614-0829.

What is Skylette Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Skylette Jackson enrolled in Medicare?

Yes. Skylette Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Skylette Jackson was last updated on April 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.