Ms Alicia (ali) Jackson, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Cypress, NA. Her current practice location is
15040 Fairfield Place, Cypress, NA. You can reach out to her office (for appointments etc.) via phone at
(281) 652-7468.
Ms Alicia (ali) Jackson is licensed to practice in Texas (license number 51227) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1366082752.
Healthcare Provider's Profile
| Full Name | Ms Alicia (ali) Jackson |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 15040 Fairfield Place, Cypress, NA |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1366082752
- Provider Enumeration Date: 01/14/2020
- Last Update Date: 10/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 9335514314
- Enrollment ID: I20230404002381
Medical Identifiers
Medical identifiers for Ms Alicia (ali) Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366082752 | NPI | - | NPPES |
| 51227 | Other | TX | LCSW |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | 51227 (Texas) | 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. Ms Alicia (ali) Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Sondermind Provider Network Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760854442
PECOS PAC ID: 9537572490
Enrollment ID: O20210326001541 |
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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. Ms Alicia (ali) 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 |
|---|
Ms Alicia (ali) Jackson, LCSW
15507 Valley Plum Ct,
Cypress, TX 77433-6010
Ph: (281) 652-7468 | Ms Alicia (ali) Jackson, LCSW
15040 Fairfield Place,
Cypress, NA 77433
Ph: (281) 652-7468 |
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