Kelly Jackson, LCSW-C - Medicare Clinical Social Worker in National Harbor, MD

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Kelly Jackson, LCSW-C is a medicare enrolled "Social Worker - Clinical" provider in National Harbor, Maryland. She graduated from medical school in 2013 and has 11 years of diverse experience with area of expertise as Clinical Social Worker. Her current practice location is 137 National Plaza, Suite 300, National Harbor, Maryland. You can reach out to her office (for appointments etc.) via phone at (301) 395-9033.

Kelly Jackson is licensed to practice in Maryland (license number 20520) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1710435953.

Contact Information

Kelly Jackson, LCSW-C
137 National Plaza, Suite 300,
National Harbor, MD 20745
(301) 395-9033
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameKelly Jackson
GenderFemale
SpecialityClinical Social Worker
Experience11 Years
Location137 National Plaza, National Harbor, Maryland
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kelly Jackson graduated from medical school in 2013
  NPI Data:
  • NPI Number: 1710435953
  • Provider Enumeration Date: 09/16/2016
  • Last Update Date: 01/03/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3476892068
  • Enrollment ID: I20190226001346

Medical Identifiers

Medical identifiers for Kelly Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710435953NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical LG50081123 (District Of Columbia)Secondary
1041C0700XSocial Worker - Clinical 0904011702 (Virginia)Secondary
1041C0700XSocial Worker - Clinical 20520 (Maryland)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Jackson allows following entities to bill medicare on her behalf.
Entity NameChanging Tides Counseling & Behavioral Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841859931
PECOS PAC ID: 3971838541
Enrollment ID: O20190718002504

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly Jackson, LCSW-C
Po Box 2628,
Waldorf, MD 20604-2628

Ph: (951) 977-1388		Kelly Jackson, LCSW-C
137 National Plaza, Suite 300,
National Harbor, MD 20745

Ph: (301) 395-9033

Reviews and Comments


Social Worker in National Harbor, MD


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.