Mr Deric R Jackson, LICSW in Hastings, MN - Medicare Social Worker Provider

Mr Deric R Jackson, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Hastings, Minnesota. His current practice location is 1320 S Frontage Rd Ste 200, Hastings, Minnesota. You can reach out to his office (for appointments etc.) via phone at (651) 500-0905.

Mr Deric R Jackson is licensed to practice in Minnesota (license number 21544) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1093423337.

Contact Information

	Mr Deric R Jackson, LICSW
	1320 S Frontage Rd Ste 200, Hastings, MN 55033-2481
	(651) 500-0905
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Deric R Jackson
Gender	Male
Speciality	Social Worker - Clinical
Location	1320 S Frontage Rd Ste 200, Hastings, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1093423337
Provider Enumeration Date: 11/07/2022
Last Update Date: 11/28/2022

Medicare PECOS Information:

PECOS PAC ID: 1153863451
Enrollment ID: I20240601000294

Medical Identifiers

Medical identifiers for Mr Deric R Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093423337	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	21544 (Minnesota)	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. Mr Deric R Jackson allows following entities to bill medicare on his behalf.

Entity Name	Minnesota Counseling And Therapy Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659761633 PECOS PAC ID: 1456893759 Enrollment ID: O20240601000159

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. Mr Deric R 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 Address	Practice Location Address
Mr Deric R Jackson, LICSW 1320 S Frontage Rd, Hastings, MN 55033-2684 Ph: (651) 500-0905	Mr Deric R Jackson, LICSW 1320 S Frontage Rd Ste 200, Hastings, MN 55033-2481 Ph: (651) 500-0905

Reviews and Comments

Social Worker in Hastings, MN

Jane Victoria Schwark, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1600 Highway 55, Hastings, MN 55033 Phone: 651-438-8219 Fax: 651-438-8252
Jenna Triscari, MSW, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1880 N Frontage Rd, Hastings, MN 55033 Phone: 651-438-1800
Ms. Patricia Dorothy Gosz, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1200 18th St E, Hastings, MN 55033 Phone: 651-438-8526 Fax: 651-437-2012
Michaela J. Burr, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1320 S Frontage Rd, Suite 200, Hastings, MN 55033 Phone: 651-500-0905 Fax: 651-437-2616
Terra Larae Pingley, MSW, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1320 S Frontage Rd Ste 200, Hastings, MN 55033 Phone: 612-900-4354
Aaron Joshua Kennell, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1303 S Frontage Rd Ste 221, Hastings, MN 55033 Phone: 224-424-4194

Mr Deric R Jackson, LICSW - Medicare Clinical Social Worker in Hastings, MN