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MRS. ROBERTA MARIE JACKSON LCSW CASAC-II
NPI 1760013353
Social Worker - Clinical in New York, NY

Active since January 31, 2020PECOS Enrolled
105 W 125TH ST, FRONT 1 #1042, NEW YORK, NY 10027(347) 654-4405(646) 759-4019 Get Directions Write a Review

NPPES record last updated: August 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 8, 2023, Feb 9, 2023, Jan 31, 2020 (3 updates tracked since 2020).

About Mrs. Roberta Marie Jackson Lcsw Casac-ii NPPES

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

MRS. ROBERTA MARIE JACKSON LCSW CASAC-II (NPI 1760013353) is an individual clinical provider in New York, New York, licensed in New York (088300-01) and active in the NPI registry since January 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1760013353
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. ROBERTA MARIE JACKSONCredential: LCSW CASAC-II
Location Address105 W 125TH ST, FRONT 1 #1042New York, NY 10027-4444
Mailing Address105 West 125th St, Front 1 #1042New York, NY 10027-4444 · (475) 900-6271 · Fax (646) 759-4019
Phone(347) 654-4405
Fax(646) 759-4019
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJanuary 31, 2020
Last NPPES UpdateAugust 30, 20243 updates tracked since enumeration
NPPES CertifiedAugust 30, 2024
✔ NPI 1760013353 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
License✔ Licensed in NY · 088300-01
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 ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 35723 (NY)
105 W 125TH ST, New York, NY 10027
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Other Names 1

Former Name (1)Ms. Roberta Marie Walker Lmsw

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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)

Mrs. Roberta Marie Jackson Lcsw Casac-ii is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719335462
PECOS Enrollment IDI20231120000558
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 10027 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 $65.69 – $198.19
Typical copayment $0.00 (range $16.42 – $49.54)
Most-billed visit code NA
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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 2

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

LAURIE VAL
Counselor (Mental Health)
105 W 125TH ST
NEW YORK, NY 10027
New York County (201) 365-4037
ELLIOTT EZELLE HEWETT LCSW
Social Worker (Clinical)
105 W 125TH ST
NEW YORK, NY 10027
New York County (201) 365-4037

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 Roberta Jackson's NPI number?

The NPI number for Roberta Jackson is 1760013353. It was assigned to this individual provider in the NPPES registry on January 31, 2020. The provider is also known as Ms. Roberta Marie Walker Lmsw.

Where is Roberta Jackson located?

Roberta Jackson practices at 105 W 125th St Front 1 #1042, New York, NY 10027. The listed phone number is (347) 654-4405.

What is Roberta Jackson's specialty?

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

Is Roberta Jackson enrolled in Medicare?

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

What insurance does Roberta Jackson accept?

Health plans from Providence Health Plan list Roberta 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 Roberta Jackson was last updated on August 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.