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ANGELA JACKSON LISW-CP
NPI 1922511419
Social Worker - Clinical in Irmo, SC

Active since November 07, 2017PECOS EnrolledAccepts Medicare Assignment
1180 COLUMBIA AVE STE 101, IRMO, SC 29063(803) 575-0579(803) 830-3873 Get Directions Write a Review

NPPES record last updated: April 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 14, 2023, Jan 4, 2023, Mar 11, 2021 and 3 more (6 updates tracked since 2017).

About Angela Jackson Lisw-cp NPPES

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

ANGELA JACKSON LISW-CP (NPI 1922511419) is an individual clinical provider in Irmo, South Carolina, licensed in South Carolina (13959) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1922511419
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameANGELA JACKSONCredential: LISW-CP
Location Address1180 COLUMBIA AVE STE 101Irmo, SC 29063-2890
Mailing Address1180 Columbia Ave Ste 101Irmo, SC 29063-2890 · (803) 575-0579 · Fax (803) 830-3873
Phone(803) 575-0579
Fax(803) 830-3873
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 7, 2017
Last NPPES UpdateApril 14, 20236 updates tracked since enumeration
NPPES CertifiedApril 14, 2023
✔ NPI 1922511419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in SC · 13959
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.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
1180 COLUMBIA AVE STE 101, Irmo, SC 29063
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Other Identifiers 1

MedicaidSW1739SC

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

Angela Jackson Lisw-cp 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 ID840603346
PECOS Enrollment IDI20210423002122
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 29063 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 $53.57 – $163.84
Typical copayment $0.00 (range $13.39 – $40.96)
Most-billed visit code NA
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
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 2

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

BETHANIE BROWN LISW-CP
Social Worker (Clinical)
1180 COLUMBIA AVE STE 101
IRMO, SC 29063
Lexington County (864) 325-4563
MY PURPOSE COUNSELING, LLC
Counselor (Professional)
1180 COLUMBIA AVE STE 101
IRMO, SC 29063
Lexington County (803) 274-1268

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 Angela Jackson's NPI number?

The NPI number for Angela Jackson is 1922511419. It was assigned to this individual provider in the NPPES registry on November 7, 2017.

Where is Angela Jackson located?

Angela Jackson practices at 1180 Columbia Ave Ste 101, Irmo, SC 29063. The listed phone number is (803) 575-0579.

What is Angela Jackson's specialty?

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

Is Angela Jackson enrolled in Medicare?

Yes. Angela 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.

When was this NPI record last updated?

The NPPES record for Angela Jackson was last updated on April 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.