Mr Brian M Jackson, LPC in Coburg, OR - Medicare Counselor Provider

Mr Brian M Jackson, LPC is a medicare enrolled "Counselor - Professional" provider in Coburg, Oregon. His current practice location is 91150 Coburg Industrial Way Serenity Lane, Coburg, Oregon. You can reach out to his office (for appointments etc.) via phone at (541) 687-1110.

Mr Brian M Jackson is licensed to practice in Oregon (license number C5715) 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 1275048167.

Contact Information

	Mr Brian M Jackson, LPC
	91150 Coburg Industrial Way Serenity Lane, Coburg, OR 97408
	(541) 687-1110
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Brian M Jackson
Gender	Male
Speciality	Counselor - Professional
Location	91150 Coburg Industrial Way Serenity Lane, Coburg, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1275048167
Provider Enumeration Date: 12/13/2017
Last Update Date: 04/08/2021

Medicare PECOS Information:

PECOS PAC ID: 8729421870
Enrollment ID: I20240206003251

Medical Identifiers

Medical identifiers for Mr Brian M Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275048167	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	LPC-13803 (Arizona)	Secondary
101YP2500X	Counselor - Professional	C5715 (Oregon)	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 Brian M Jackson allows following entities to bill medicare on his behalf.

Entity Name	Lisa J Griffin
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1336678952 PECOS PAC ID: 7214263755 Enrollment ID: O20190722003139

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 Brian M 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 Brian M Jackson, LPC P.o. Box 8549 Serenity Lane, 91150 Coburg Industrial Way, Coburg, OR 97408 Ph: (541) 687-1110	Mr Brian M Jackson, LPC 91150 Coburg Industrial Way Serenity Lane, Coburg, OR 97408 Ph: (541) 687-1110

Reviews and Comments

Counselor in Coburg, OR

Kara Lonberg, CADC 2 Counselor Medicare: Not Enrolled in Medicare Practice Location: 91150 N Coburg Industrial Way, Coburg, OR 97408 Phone: 541-284-5652 Fax: 541-465-3148
Geramie Mark Mccormick, CRM II, CADC-R Counselor Medicare: Not Enrolled in Medicare Practice Location: 91150 N Coburg Industrial Way, Coburg, OR 97408 Phone: 541-284-5645
Tanja Desalles Looker, CADC 1 Counselor Medicare: Not Enrolled in Medicare Practice Location: 91150 N Coburg Industrial Way, Coburg, OR 97408 Phone: 541-284-5709
Mason Anthony Marin, CADC-R, CRM 1 Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Serenity Ln, Coburg, OR 97408 Phone: 541-606-3308
Jeffrey Hugh Wright, Counselor Medicare: Not Enrolled in Medicare Practice Location: 91150 N Coburg Industrial Way, Coburg, OR 97408 Phone: 541-687-1110
Jenae Hulsey Katelyn Hulsey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Serenity Ln, Coburg, OR 97408 Phone: 541-687-1110
Jaclyn Bogner, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Serenity Ln, Coburg, OR 97408 Phone: 541-687-1110

Mr Brian M Jackson, LPC - Medicare Counselor in Coburg, OR