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

Q: 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.

Q: What is Serena Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Serena Jackson was last updated on December 29, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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: July 19, 2026.

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

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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, and ordering and referring status from the CMS PECOS system.

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.

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.

DR. TIMOTHY JOSEPH CATLOW PSY.D.

Psychologist