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MR. RICHARD BRENDAN JACKSON LPC, LMAC-T
NPI 1912500554
Counselor - Mental Health in Shawnee, KS

Active since November 17, 2020PECOS EnrolledAccepts Medicare Assignment
6221 RICHARDS DR, SHAWNEE, KS 66216(913) 248-1943 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Richard Brendan Jackson Lpc, Lmac-t NPPES

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

MR. RICHARD BRENDAN JACKSON LPC, LMAC-T (NPI 1912500554) is an individual mental health provider in Shawnee, Kansas, licensed in Kansas (03696) and active in the NPI registry since November 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1912500554
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. RICHARD BRENDAN JACKSONCredential: LPC, LMAC-T
Location Address6221 RICHARDS DRShawnee, KS 66216-1724
Mailing Address6221 Richards DrShawnee, KS 66216-1724 · (913) 248-1943
Phone(913) 248-1943
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateNovember 17, 2020
NPPES CertifiedNovember 17, 2020
✔ NPI 1912500554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in KS · 03696
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 00906-T (KS)
6221 RICHARDS DR, Shawnee, KS 66216
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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

Mr. Richard Brendan Jackson Lpc, Lmac-t 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 ID4789167297
PECOS Enrollment IDI20260312003151
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 Richard Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wyandot Center For Community Behavioral Healthcare, Inc.
7.6 mi
Community/Behavioral Health
1301 N 47TH ST
Kansas City, KS 66102
  • Reassigned Medicare billing, Kansas enrollment
  • 53 clinicians in this Medicare group
NPI 1629159389 (913) 287-0007

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 17

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

DOUGLAS JOHNSON LAC
Counselor (Addiction (Substance Use Disorder))
6221 RICHARDS DR
SHAWNEE, KS 66216
Johnson County (913) 248-1943
SUE JACOBSON LAC
Counselor (Addiction (Substance Use Disorder))
6221 RICHARDS DR
SHAWNEE, KS 66216
Johnson County (913) 248-1943
MEGAN KWILINSKI
Counselor (Addiction (Substance Use Disorder))
6221 RICHARDS DR
SHAWNEE, KS 66216
Johnson County (316) 283-6743
JOIE BETH FREIRICH
Social Worker (Clinical)
6221 RICHARDS DR
SHAWNEE, KS 66216
Johnson County (913) 766-1587
MICHELLE BUSH LAC
Counselor (Addiction (Substance Use Disorder))
6221 RICHARDS DR
SHAWNEE, KS 66216
Johnson County (913) 248-1943
RACHEL C KELLY LPC
Psychologist (Addiction (Substance Use Disorder))
6221 RICHARDS DR
SHAWNEE, KS 66216
Johnson County (913) 248-1943
JASON DONLON LAC
Counselor (Addiction (Substance Use Disorder))
6221 RICHARDS DR
SHAWNEE, KS 66216
Johnson County (913) 248-1943
RACHAEL DOWNING
Counselor (Addiction (Substance Use Disorder))
6221 RICHARDS DR
SHAWNEE, KS 66216
Johnson County (316) 283-6743

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 Richard Jackson's NPI number?

The NPI number for Richard Jackson is 1912500554. It was assigned to this individual provider in the NPPES registry on November 17, 2020.

Where is Richard Jackson located?

Richard Jackson practices at 6221 Richards Dr, Shawnee, KS 66216. The listed phone number is (913) 248-1943.

What is Richard Jackson's specialty?

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

Is Richard Jackson enrolled in Medicare?

Yes. Richard 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 Richard Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Richard Jackson reassigns Medicare benefits to Wyandot Center For Community Behavioral Healthcare, Inc. (Kansas City, KS). 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 Richard Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Richard Jackson was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.