ANTIONETTE MARIE JACKSON
NPI 1649864885
Counselor - Mental Health in Crawfordville, FL

Active since March 01, 2021PECOS Enrolled
110 MELALEUCA DR, CRAWFORDVILLE, FL 32327(850) 617-9167 Get Directions Write a Review

NPPES record last updated: March 1, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Antionette Marie Jackson NPPES

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

ANTIONETTE MARIE JACKSON (NPI 1649864885) is an individual mental health provider in Crawfordville, Florida and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1649864885
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameANTIONETTE MARIE JACKSON
Location Address110 MELALEUCA DRCrawfordville, FL 32327-4963
Mailing Address350 N Charles Willis DrMidway, FL 32343-4293 · (850) 694-7555
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 1, 2021
NPPES CertifiedMarch 1, 2021
NPI 1649864885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
110 MELALEUCA DR, Crawfordville, FL 32327

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Antionette Marie Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820515992
PECOS Enrollment IDI20250620002569
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 4

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

Physician Assistant
110 MELALEUCA DR
CRAWFORDVILLE, FL 32327
Nurse Practitioner (Psychiatric/Mental Health)
110 MELALEUCA DR
CRAWFORDVILLE, FL 32327
Nurse Practitioner (Family)
110 MELALEUCA DR
CRAWFORDVILLE, FL 32327
Social Worker (Clinical)
110 MELALEUCA DR
CRAWFORDVILLE, FL 32327

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 Antionette Jackson's NPI number?

The NPI number for Antionette Jackson is 1649864885. It was assigned to this individual provider in the NPPES registry on March 1, 2021.

Where is Antionette Jackson located?

Antionette Jackson practices at 110 Melaleuca Dr, Crawfordville, FL 32327. The listed phone number is (850) 617-9167.

What is Antionette Jackson's specialty?

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

Is Antionette Jackson enrolled in Medicare?

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

What insurance does Antionette Jackson accept?

Health plans from Blue Cross and Blue Shield of Texas, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and Oscar Insurance Company and 2 other insurers list Antionette 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 Antionette Jackson was last updated on March 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.