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JYLIAN ANN JACKSON LMSW
NPI 1982236022
Social Worker in Port Jervis, NY

Active since February 06, 2020PECOS Enrolled
146 PIKE STREET OUTPATIENT CLINIC, PORT JERVIS, NY 12771(845) 858-1456 Get Directions Write a Review

NPPES record last updated: February 19, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 19, 2025, Feb 7, 2020 (2 updates tracked since 2020).

About Jylian Ann Jackson Lmsw NPPES

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

JYLIAN ANN JACKSON LMSW (NPI 1982236022) is an individual social worker in Port Jervis, New York, licensed in New York (107538) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Newburgh.

NPPES Registry Identity

NPI1982236022
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameJYLIAN ANN JACKSONCredential: LMSW
Location Address146 PIKE STREET OUTPATIENT CLINICPort Jervis, NY 12771
Mailing Address30 Harriman DrGoshen, NY 10924-2410 · (845) 291-2600
Phone(845) 858-1456
Sole ProprietorYes
Enumeration DateFebruary 6, 2020
Last NPPES UpdateFebruary 19, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2025
✔ NPI 1982236022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in NY · 107538
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 099243 (NY)
146 PIKE STREET OUTPATIENT CLINIC, Port Jervis, NY 12771
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Secondary Practice Location 1

Location 1141 BroadwayNewburgh, NY 12550-6204 · Phone (845) 568-5260 · Fax (845) 568-5213

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jylian Ann Jackson Lmsw 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.

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 Jylian Jackson's NPI number?

The NPI number for Jylian Jackson is 1982236022. It was assigned to this individual provider in the NPPES registry on February 6, 2020.

Where is Jylian Jackson located?

Jylian Jackson practices at 146 Pike Street Outpatient Clinic, Port Jervis, NY 12771. The listed phone number is (845) 858-1456.

What is Jylian Jackson's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Jylian Jackson enrolled in Medicare?

Yes. Jylian Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jylian Jackson was last updated on February 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.