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VIVIAN ANN JACKSON LMHC
NPI 1922210210
Counselor - Mental Health in Starke, FL

Active since May 07, 2007PECOS EnrolledAccepts Medicare Assignment
945 GRAND ST, STARKE, FL 32091(352) 374-5600 Get Directions Write a Review

NPPES record last updated: March 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Vivian Ann Jackson Lmhc NPPES

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

VIVIAN ANN JACKSON LMHC (NPI 1922210210) is an individual mental health provider in Starke, Florida, licensed in Florida (MH17142) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1922210210
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameVIVIAN ANN JACKSONCredential: LMHC
Location Address945 GRAND STStarke, FL 32091-1821
Mailing Address4300 Sw 13th StGainesville, FL 32608-4006 · (352) 374-5600 · Fax (352) 224-2741
Phone(352) 374-5600
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateMay 7, 2007
Last NPPES UpdateMarch 23, 2022
NPPES CertifiedMarch 23, 2022
✔ NPI 1922210210 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 FL · MH17142
945 GRAND ST, Starke, FL 32091
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Vivian Ann Jackson Lmhc 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 ID8628411378
PECOS Enrollment IDI20240209000041
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
1,388 services141 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
112 services105 patients
Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
11 services11 patients

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.

DUANE FARR
Case Manager/Care Coordinator
945 GRAND ST
STARKE, FL 32091
Bradford County (352) 374-5600
MERIDIAN BEHAVIORAL HEALTHCARE
Community/Behavioral Health
945 GRAND ST
STARKE, FL 32091
Bradford County (904) 964-4827
SHIRA CALLAHAN
Counselor
945 GRAND ST
STARKE, FL 32091
Bradford County (352) 374-5600
ANTWAR V JELKS
Case Manager/Care Coordinator
945 GRAND ST
STARKE, FL 32091
Bradford County (904) 964-8382
CHRISTOPHER WALKER
Counselor
945 GRAND ST
STARKE, FL 32091
Bradford County (352) 374-5600
CHAREISHA JONAS
Counselor
945 GRAND ST
STARKE, FL 32091
Bradford County (352) 374-5600
PATRICK MCMILLIN
Case Manager/Care Coordinator
945 GRAND ST
STARKE, FL 32091
Bradford County (352) 374-5600
TENIKA GRAY
Counselor
945 GRAND ST
STARKE, FL 32091
Bradford County (352) 374-5600

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 Vivian Jackson's NPI number?

The NPI number for Vivian Jackson is 1922210210. It was assigned to this individual provider in the NPPES registry on May 7, 2007.

Where is Vivian Jackson located?

Vivian Jackson practices at 945 Grand St, Starke, FL 32091. The listed phone number is (352) 374-5600.

What is Vivian Jackson's specialty?

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

Is Vivian Jackson enrolled in Medicare?

Yes. Vivian 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.

What insurance does Vivian Jackson accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Vivian 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 Vivian Jackson was last updated on March 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.