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SERENA LEIGH JACKSON
NPI 1871295816
Counselor - Professional in Corvallis, OR

Active since March 21, 2023PECOS Enrolled
4455 NE HIGHWAY 20, CORVALLIS, OR 97330(541) 758-5900 Get Directions Write a Review

NPPES record last updated: December 29, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 29, 2025, Mar 21, 2023 (2 updates tracked since 2023).

About Serena Leigh Jackson NPPES

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

SERENA LEIGH JACKSON (NPI 1871295816) is an individual professional provider in Corvallis, Oregon, licensed in Oregon (C11072) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1871295816
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameSERENA LEIGH JACKSON
Location Address4455 NE HIGHWAY 20Corvallis, OR 97330-9695
Mailing Address3415 Se Powell BlvdPortland, OR 97202-3371 · (959) 150-3234
Phone(541) 758-5900
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 21, 2023
Last NPPES UpdateDecember 29, 20252 updates tracked since enumeration
NPPES CertifiedDecember 29, 2025
✔ NPI 1871295816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OR · C11072
Also ListedArt TherapistTaxonomy 221700000X
4455 NE HIGHWAY 20, Corvallis, OR 97330
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Serena Leigh Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143797621
PECOS Enrollment IDI20260422002369
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 Serena Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA
2,717 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Oregon enrollment
  • 285 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

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 20

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

GEORGE WILLIAM KEMPER JR.
Social Worker
4455 NE HIGHWAY 20
CORVALLIS, OR 97330
Benton County (541) 758-5944
KIRI N. HORSEY MS, LPC
Counselor (Mental Health)
4455 NE HIGHWAY 20
CORVALLIS, OR 97330
Benton County (541) 758-5946
MS. CASEY JOANNA ROACH MA
Counselor (Mental Health)
4455 NE HIGHWAY 20
CORVALLIS, OR 97330
Benton County (541) 758-5900
PATRICK OWEN MCGUFFIN
Counselor
4455 NE HIGHWAY 20
CORVALLIS, OR 97330
Benton County (541) 758-5900
LAURA CAPEHART
Counselor
4455 NE HIGHWAY 20
CORVALLIS, OR 97330
Benton County (541) 758-5900
DEVAN COMPTON
Counselor (Mental Health)
4455 NE HIGHWAY 20
CORVALLIS, OR 97330
Benton County (503) 234-9591
ANNA SPROSS
Counselor
4455 NE HIGHWAY 20
CORVALLIS, OR 97330
Benton County (541) 757-1852
VICTORIA ALEXANDRA ODELL
Counselor
4455 NE HIGHWAY 20
CORVALLIS, OR 97330
Benton County (541) 758-5900

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 Serena Jackson's NPI number?

The NPI number for Serena Jackson is 1871295816. It was assigned to this individual provider in the NPPES registry on March 21, 2023.

Where is Serena Jackson located?

Serena Jackson practices at 4455 NE Highway 20, Corvallis, OR 97330. The listed phone number is (541) 758-5900.

What is Serena Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Serena Jackson enrolled in Medicare?

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

Which organization bills Medicare for Serena Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Serena Jackson reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). 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 Serena Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Serena Jackson accept?

Health plans from Moda Health Plan, Inc. list Serena 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 Serena Jackson was last updated on December 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.