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ANDREA LANE JACKSON LICSW, LCSW
NPI 1679003099
Social Worker - Clinical in Washington, DC

Active since June 18, 2017PECOS Enrolled
1763 COLUMBIA RD NW STE 175, WASHINGTON, DC 20009(202) 318-3997(202) 318-0501 Get Directions Write a Review

NPPES record last updated: August 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Apr 19, 2022, Mar 17, 2018 and 2 more (5 updates tracked since 2017).

About Andrea Lane Jackson Licsw, Lcsw NPPES

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

ANDREA LANE JACKSON LICSW, LCSW (NPI 1679003099) is an individual clinical provider in Washington, District Of Columbia, licensed in District Of Columbia (LC200003614) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679003099
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameANDREA LANE JACKSONCredential: LICSW, LCSW
Location Address1763 COLUMBIA RD NW STE 175Washington, DC 20009-2891
Mailing Address1763 Columbia Rd Nw Ste 175Washington, DC 20009-2891 · (202) 381-3997
Phone(202) 318-3997
Fax(202) 318-0501
Sole ProprietorYes
Enumeration DateJune 18, 2017
Last NPPES UpdateAugust 18, 20255 updates tracked since enumeration
NPPES CertifiedAugust 18, 2025
✔ NPI 1679003099 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in DC · LC200003614✔ Licensed in VA · 0904017420✔ Licensed in NY · 091378
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.
Also ListedSocial WorkerTaxonomy 104100000X · License 087822 (NY)
1763 COLUMBIA RD NW STE 175, Washington, DC 20009
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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)

Andrea Lane Jackson Licsw, Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 20009 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 $65.18 – $194.86
Typical copayment $0.00 (range $16.29 – $48.71)
Most-billed visit code NA
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
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 4

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

CARDINAL HOPE AND HEALING LLC
Social Worker (Clinical)
1763 COLUMBIA RD NW STE 175
WASHINGTON, DC 20009
District of Columbia (202) 318-3997
LOGISTIC IDEAS TRANSPORTATION
Non-emergency Medical Transport (VAN)
1763 COLUMBIA RD NW STE 175
WASHINGTON, DC 20009
District of Columbia (771) 242-0859
RESILIENCE LLC
Case Management
1763 COLUMBIA RD NW STE 175
WASHINGTON, DC 20009
District of Columbia (470) 236-3738
SUNDAYRESETDC PLLC
Nurse Practitioner
1763 COLUMBIA RD NW STE 175
WASHINGTON, DC 20009
District of Columbia (571) 265-6624

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 Andrea Jackson's NPI number?

The NPI number for Andrea Jackson is 1679003099. It was assigned to this individual provider in the NPPES registry on June 18, 2017.

Where is Andrea Jackson located?

Andrea Jackson practices at 1763 Columbia Rd NW Ste 175, Washington, DC 20009. The listed phone number is (202) 318-3997.

What is Andrea Jackson's specialty?

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

Is Andrea Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Andrea Jackson was last updated on August 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.