Jackson T Douglas, LPC in Springfield, MO - Medicare Counselor Provider

Jackson T Douglas, LPC is a medicare enrolled "Counselor - Professional" provider in Springfield, Missouri. His current practice location is 1300 E Bradford Pkwy, Springfield, Missouri. You can reach out to his office (for appointments etc.) via phone at (417) 761-5000.

Jackson T Douglas is licensed to practice in Missouri (license number 2014040178) 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 1356695183.

Contact Information

	Jackson T Douglas, LPC
	1300 E Bradford Pkwy, Springfield, MO 65804-4264
	(417) 761-5000
	(417) 761-5111

Map and Direction

Healthcare Provider's Profile

Full Name	Jackson T Douglas
Gender	Male
Speciality	Counselor - Professional
Location	1300 E Bradford Pkwy, Springfield, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1356695183
Provider Enumeration Date: 10/31/2012
Last Update Date: 08/22/2022

Medicare PECOS Information:

PECOS PAC ID: 7517317878
Enrollment ID: I20231228002073

Medical Identifiers

Medical identifiers for Jackson T Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356695183	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	(* (Not Available))	Secondary
101YP2500X	Counselor - Professional	2014040178 (Missouri)	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. Jackson T Douglas allows following entities to bill medicare on his behalf.

Entity Name	Clark Community Mental Health Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801807771 PECOS PAC ID: 8527069277 Enrollment ID: O20070123000267

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. Jackson T Douglas 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
Jackson T Douglas, LPC 1300 E Bradford Pkwy, Springfield, MO 65804-4264 Ph: (417) 761-5000	Jackson T Douglas, LPC 1300 E Bradford Pkwy, Springfield, MO 65804-4264 Ph: (417) 761-5000

Reviews and Comments

Counselor in Springfield, MO

Mrs. Rebecca J Barratt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2131 S Eastgate Ave, Springfield, MO 65809 Phone: 417-763-3309 Fax: 417-763-3331
Mrs. Lori Renee Radford, PLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1041 E Walnut St, Springfield, MO 65806 Phone: 417-459-2117
Stephanie J Robbins, MS, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1350 E Bradford Pkwy, Springfield, MO 65804 Phone: 417-761-5850
Brian Vega, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1531 E Sunshine St, Ste W-29, Springfield, MO 65804 Phone: 417-887-9950 Fax: 417-888-0226
Linda L. Britt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 636 W Republic Rd Ste G100, Springfield, MO 65807 Phone: 417-862-8282 Fax: 417-862-8805
Ms. Jessica Ann Heavin, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2200 E Sunshine St Ste 338, Springfield, MO 65804 Phone: 417-823-8000 Fax: 417-823-9334
Angie Fitzpatrick, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1613 W Elfindale St, Springfield, MO 65807 Phone: 417-864-7921

Jackson T Douglas, LPC - Medicare Counselor in Springfield, MO