MELLISSA FORDE-JACKSON LCSW
NPI 1922406842
Social Worker - Clinical in Fayetteville, NC

Q: What is Mellissa Forde-jackson's NPI number?

The NPI number for Mellissa Forde-jackson is 1922406842. It was assigned to this individual provider in the NPPES registry on December 9, 2014. The provider is also known as Mellissa Alysha Forde-Jackson Lcsw.

Q: What is Mellissa Forde-jackson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since December 09, 2014PECOS Enrolled

911 HAY ST, FAYETTEVILLE, NC 28305(910) 827-6649(910) 438-0942 Get Directions Write a Review

NPPES record last updated: March 8, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mellissa Forde-jackson Lcsw NPPES

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

MELLISSA FORDE-JACKSON LCSW (NPI 1922406842) is an individual clinical provider in Fayetteville, North Carolina, licensed in North Carolina (C010681) and active in the NPI registry since December 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922406842

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMELLISSA FORDE-JACKSONCredential: LCSW

Location Address911 HAY STFayetteville, NC 28305-5313

Mailing Address123 Harmony Hall WayFayetteville, NC 28303 · (706) 231-7025

Phone(910) 827-6649

Fax(910) 438-0942

Sole ProprietorYes

Enumeration DateDecember 9, 2014

Last NPPES UpdateMarch 8, 2023

NPPES CertifiedMarch 3, 2023

✔ NPI 1922406842 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NC · C010681

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

911 HAY ST, Fayetteville, NC 28305

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Other Names 1

Professional Name (2)Mellissa Alysha Forde-jackson Lcsw

Other Identifiers 1

OtherC010681NC · North Carolina Social Work Certification And Licensure Board

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Providence Health Plan, UnitedHealthcare.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)

Mellissa Forde-jackson Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $54.12 – $165.09

Typical copayment $0.00 (range $13.53 – $41.27)

Most-billed visit code NA

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

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