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JENNIFER R JACKSON LPC
NPI 1811377161
Counselor - Mental Health in Mesa, AZ

Active since June 02, 2015PECOS EnrolledAccepts Medicare Assignment
2120 W GUADALUPE RD STE 6, MESA, AZ 85202(602) 230-7373(480) 629-8577 Get Directions Write a Review

NPPES record last updated: December 5, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jennifer R Jackson Lpc NPPES

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

JENNIFER R JACKSON LPC (NPI 1811377161) is an individual mental health provider in Mesa, Arizona, licensed in Arizona (LPC-23931) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1811377161
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJENNIFER R JACKSONCredential: LPC
Location Address2120 W GUADALUPE RD STE 6Mesa, AZ 85202-7366
Mailing Address3101 N Central Ave Ste 550Phoenix, AZ 85012-2635 · (602) 230-7373 · Fax (602) 682-7455
Phone(602) 230-7373
Fax(480) 629-8577
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJune 2, 2015
Last NPPES UpdateDecember 5, 2025
NPPES CertifiedDecember 5, 2025
✔ NPI 1811377161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in AZ · LPC-23931
2120 W GUADALUPE RD STE 6, Mesa, AZ 85202
Open in Google Maps ↗

Secondary Practice Location 1

Location 12102 W Bethany Home RdPhoenix, AZ 85015-1935 · Phone (602) 774-4745

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jennifer R Jackson Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527509355
PECOS Enrollment IDI20241002003685
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Jennifer Jackson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Denova Collaborative Health, LLC
Same address
Multi-Specialty
2120 W GUADALUPE RD STE 6
Mesa, AZ 85202
  • Reassigned Medicare billing, Arizona enrollment
  • 282 clinicians in this Medicare group
NPI 1124549043 (602) 230-7373
Integrative Psychotherapy And Assessment Services
21 mi
Psychologist
11024 N 28TH DR, SUITE 200
Phoenix, AZ 85029
  • Reassigned Medicare billing, Arizona enrollment
  • 11 clinicians in this Medicare group
NPI 1699146910 (602) 526-8315
Mental Health Specialty Group PA
1,878 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Arizona enrollment
  • 99 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088

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

Other Providers at the Same Location NPPES 15

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

DR. JESUS PRADO DNP, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
2120 W GUADALUPE RD STE 6
MESA, AZ 85202
Maricopa County (602) 230-7373
MARK ALLEN WILLIAMS PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
2120 W GUADALUPE RD STE 6
MESA, AZ 85202
Maricopa County (602) 230-7373
DENOVA COLLABORATIVE HEALTH, LLC
Clinic/Center (Multi-Specialty)
2120 W GUADALUPE RD STE 6
MESA, AZ 85202
Maricopa County (602) 230-7373
MS. JOY O. AGEH LPC
Counselor (Professional)
2120 W GUADALUPE RD STE 6
MESA, AZ 85202
Maricopa County (602) 230-7373
MICHAEL BERGSTROM LMFT
Marriage & Family Therapist
2120 W GUADALUPE RD STE 6
MESA, AZ 85202
Maricopa County (602) 230-7373
MS. KAREN HOUSE LPC
Counselor (Mental Health)
2120 W GUADALUPE RD STE 6
MESA, AZ 85202
Maricopa County (480) 628-8577
MS. MARJORIE SWIFT-CADY LCSW
Social Worker (Clinical)
2120 W GUADALUPE RD STE 6
MESA, AZ 85202
Maricopa County (602) 230-7373
DR. MARCUS W FOSSMEYER DNP, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
2120 W GUADALUPE RD STE 6
MESA, AZ 85202
Maricopa County (602) 230-7373

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 Jennifer Jackson's NPI number?

The NPI number for Jennifer Jackson is 1811377161. It was assigned to this individual provider in the NPPES registry on June 2, 2015.

Where is Jennifer Jackson located?

Jennifer Jackson practices at 2120 W Guadalupe Rd Ste 6, Mesa, AZ 85202. The listed phone number is (602) 230-7373.

What is Jennifer Jackson's specialty?

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

Is Jennifer Jackson enrolled in Medicare?

Yes. Jennifer Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jennifer Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Jackson reassigns Medicare benefits to 3 organizations: Denova Collaborative Health, LLC (Mesa, AZ), Integrative Psychotherapy And Assessment Services (Phoenix, AZ) and Mental Health Specialty Group PA (Durham, NC). Each 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 Jennifer Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Jackson accept?

Health plans from Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc, Oscar Health Plan, Inc. and UnitedHealthcare list Jennifer 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 Jennifer Jackson was last updated on December 5, 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.