VIVIAN ANN JACKSON LMHC
NPI 1922210210
Counselor - Mental Health in Starke, FL
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
Specialties & Licenses
Accepted 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
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.
Medicare Billing Reassignments
3Medicare enrollment records show Vivian Jackson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Maitland, FL 32751
- Reassigned Medicare billing, Florida enrollment
- 47 clinicians in this Medicare group
Tampa, FL 33602
- Reassigned Medicare billing, Florida enrollment
- 75 clinicians in this Medicare group
Shelton, CT 06484
- Reassigned Medicare billing, Florida enrollment
- 23 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
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.
Which organizations bill Medicare for Vivian Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Vivian Jackson reassigns Medicare benefits to 3 organizations: Telos Health Systems Fl LLC (Maitland, FL), Quality Bhs Florida, LLC (Tampa, FL) and Chestnut Knoll Physicians Group PC (Shelton, CT). Each 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 Vivian Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Vivian Jackson accept?
Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, 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.
# Vivian Ann Jackson, LMHC · NPI 1922210210
Mental Health provider in Starke, Florida. Individual provider, active in the CMS NPPES registry since May 7, 2007.
## Identity
- **NPI:** 1922210210 (Entity type: Individual)
- **Enumerated:** May 7, 2007
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** MH17142 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 945 GRAND ST, Starke, FL 32091-1821
- **Phone:** (352) 374-5600
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Telos Health Systems Fl LLC (NPI 1801624242, Maitland, FL); Quality Bhs Florida, LLC (NPI 1689297541, Tampa, FL); Chestnut Knoll Physicians Group PC (NPI 1780477729, Shelton, CT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** March 23, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1922210210) · Data from the CMS NPPES public registry.