Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. EDWARD L JACKSON PSYD PLLC
NPI 1669156998
Psychologist in Commerce Twp, MI

Active since June 15, 2023
2900 WELCH RD, COMMERCE TWP, MI 48390(248) 767-7927 Get Directions Write a Review

NPPES record last updated: October 7, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 7, 2026, Nov 16, 2025, Oct 5, 2023 and 2 more (5 updates tracked since 2023).

About Dr. Edward L Jackson Psyd Pllc NPPES

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

DR. EDWARD L JACKSON PSYD PLLC (NPI 1669156998) is a healthcare organization registered as a psychologist in Commerce Twp, Michigan and active in the NPI registry since June 2023. The organization maintains a secondary practice location in West Bloomfield and lists Stephanie Budry, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1669156998
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameDR. EDWARD L JACKSON PSYD PLLC
Location Address2900 WELCH RDCommerce Twp, MI 48390-1562
Mailing Address2900 Welch RdCommerce Twp, MI 48390-1562 · (248) 767-7927
Organization SubpartNo
Authorized OfficialStephanie BudryPractice Manager · (248) 376-2406
Enumeration DateJune 15, 2023
Last NPPES UpdateOctober 7, 20265 updates tracked since enumeration
NPPES CertifiedOctober 7, 2026
✔ NPI 1669156998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
2900 WELCH RD, Commerce Twp, MI 48390

Secondary Practice Location 1

Location 15777 W Maple Rd Ste 100West Bloomfield, MI 48322-2268 · Phone (248) 831-0838 · Fax (947) 251-5586

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Edward L Jackson Psyd Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Dr. Edward L Jackson Psyd PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1043606213
2900 WELCH RD
Commerce Twp, MI 48390
(248) 767-7927
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Dr. Edward L Jackson Psyd PLLC's NPI number?

The NPI number for Dr. Edward L Jackson Psyd PLLC is 1669156998. It was assigned to this organization in the NPPES registry on June 15, 2023.

Where is Dr. Edward L Jackson Psyd PLLC located?

Dr. Edward L Jackson Psyd PLLC is located at 2900 Welch Rd, Commerce Twp, MI 48390. The listed phone number is (248) 767-7927.

What is Dr. Edward L Jackson Psyd PLLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Dr. Edward L Jackson Psyd PLLC enrolled in Medicare?

Yes. Dr. Edward L Jackson Psyd PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dr. Edward L Jackson Psyd PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Dr. Edward L Jackson Psyd PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Dr. Edward L Jackson Psyd PLLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Dr. Edward L Jackson Psyd PLLC 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 Dr. Edward L Jackson Psyd PLLC was last updated on October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days 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.