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SALLY A JACKSON LCSW
NPI 1831607001
Social Worker - Clinical in Madison, WI

Active since January 22, 2018PECOS EnrolledAccepts Medicare Assignment
6502 GRAND TETON PLZ, MADISON, WI 53719(608) 827-7220(608) 827-7220 Get Directions Write a Review

NPPES record last updated: February 7, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Sally A Jackson Lcsw NPPES

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

SALLY A JACKSON LCSW (NPI 1831607001) is an individual clinical provider in Madison, Wisconsin, licensed in Wisconsin (9167-123) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1831607001
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSALLY A JACKSONCredential: LCSW
Location Address6502 GRAND TETON PLZMadison, WI 53719-1047
Mailing Address6400 Industrial LoopGreendale, WI 53129-2452 · (414) 858-4106 · Fax (414) 423-4134
Phone(608) 827-7220
Fax(608) 827-7220
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJanuary 22, 2018
Last NPPES UpdateFebruary 7, 2020
✔ NPI 1831607001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in WI · 9167-123
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.
6502 GRAND TETON PLZ, Madison, WI 53719
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan, Group Health Cooperative-SCW 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

Sally A Jackson Lcsw 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 ID2466889936
PECOS Enrollment IDI20200221001501
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 Reassignment

Medicare enrollment records show Sally Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Open Door Center For Change LLC
Same address
Mental Health (Including Community Mental Health Center)
6502 GRAND TETON PLZ STE 102
Madison, WI 53719
  • Reassigned Medicare billing, Wisconsin enrollment
  • 19 clinicians in this Medicare group
NPI 1215068069 (608) 827-7220

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53719 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 $53.90 – $163.24
Typical copayment $0.00 (range $13.47 – $40.81)
Most-billed visit code NA
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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 11

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

RACHEL S WARRICH LMFT-IT
Marriage & Family Therapist
6502 GRAND TETON PLZ
MADISON, WI 53719
Dane County (608) 827-7220
DR. CATHY A. PROPPER PH.D.
Psychologist
6502 GRAND TETON PLZ, 206
MADISON, WI 53719
Dane County (608) 827-7220
SANDREA VOELLER RDMS
Radiologic Technologist (Sonography)
6502 GRAND TETON PLZ, SUITE 105
MADISON, WI 53719
Dane County (608) 203-8333
HEATHER H DOUGLAS MS, CTRS,LPC
Counselor (Professional)
6502 GRAND TETON PLZ, SUITE 203
MADISON, WI 53719
Dane County (608) 827-7220
KAREN ANN ROMONOUSKI LCSW
Social Worker (Clinical)
6502 GRAND TETON PLZ, SUITE 206
MADISON, WI 53719
Dane County (608) 827-7220
MS. PETROVNIA FERNANDE MCINTOSH LCSW
Social Worker (Clinical)
6502 GRAND TETON PLZ, SUITE 102
MADISON, WI 53719
Dane County (608) 827-7220
MR. PATRICK FRANCIS NICHOLS LCSW CSAC
Social Worker (Clinical)
6502 GRAND TETON PLZ
MADISON, WI 53719
Dane County (608) 827-7220
EVERGREEN COUNSELING SERVICES, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
6502 GRAND TETON PLZ
MADISON, WI 53719
Dane County (608) 827-0400

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 Sally Jackson's NPI number?

The NPI number for Sally Jackson is 1831607001. It was assigned to this individual provider in the NPPES registry on January 22, 2018.

Where is Sally Jackson located?

Sally Jackson practices at 6502 Grand Teton Plz, Madison, WI 53719. The listed phone number is (608) 827-7220.

What is Sally Jackson's specialty?

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

Is Sally Jackson enrolled in Medicare?

Yes. Sally 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 organization bills Medicare for Sally Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sally Jackson reassigns Medicare benefits to Open Door Center For Change LLC (Madison, WI). The 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 Sally Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sally Jackson accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, Group Health Cooperative-SCW, Quartz and UnitedHealthcare list Sally 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 Sally Jackson was last updated on February 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.