Ms Candis L Jackson, LMHC in Port Charlotte, FL

Ms Candis L Jackson, LMHC is a medicare enrolled "Counselor - Mental Health" provider in Port Charlotte, Florida. Her current practice location is 4161 Tamiami Trl Ste 304d, Port Charlotte, Florida. You can reach out to her office (for appointments etc.) via phone at (941) 625-5895.

Ms Candis L Jackson is licensed to practice in Florida (license number MH4441) 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 1104004746.

Contact Information

	Ms Candis L Jackson, LMHC
	4161 Tamiami Trl Ste 304d, Port Charlotte, FL 33952-9254
	(941) 625-5895
	(941) 625-1047

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Candis L Jackson
Gender	Female
Speciality	Counselor - Mental Health
Location	4161 Tamiami Trl Ste 304d, Port Charlotte, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104004746
Provider Enumeration Date: 02/06/2008
Last Update Date: 05/07/2024

Medicare PECOS Information:

PECOS PAC ID: 2668814625
Enrollment ID: I20240522004291

Medical Identifiers

Medical identifiers for Ms Candis L Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104004746	NPI	-	NPPES
116480500	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	MH4441 (Florida)	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 Candis L Jackson allows following entities to bill medicare on her behalf.

Entity Name	Bennett W Mcallister Md Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1104154053 PECOS PAC ID: 3678617347 Enrollment ID: O20100218000400

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 Candis L 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 Candis L Jackson, LMHC Po Box 512139, Punta Gorda, FL 33951-2139 Ph: (941) 625-5895	Ms Candis L Jackson, LMHC 4161 Tamiami Trl Ste 304d, Port Charlotte, FL 33952-9254 Ph: (941) 625-5895

Reviews and Comments

Counselor in Port Charlotte, FL

Lori Olson, IMH Counselor Medicare: Medicare Enrolled Practice Location: 3400 Tamiami Trl, Suite 204, Port Charlotte, FL 33952 Phone: 941-629-0440
Daria Erdmann, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1680 El Jobean Rd Ste 4, Port Charlotte, FL 33948 Phone: 941-979-0121
Veronica Williams, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 21011 Nowell Ave, Port Charlotte, FL 33954 Phone: 941-250-6931
Rosalva Aguilar, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1777 Tamiami Trl Ste 201, Port Charlotte, FL 33948 Phone: 941-249-4354
Mary Tero, CAP Counselor Medicare: Medicare Enrolled Practice Location: 1777 Tamiami Trl Ste 201, Port Charlotte, FL 33948 Phone: 941-249-4354 Fax: 941-249-4356
Ms. Andrea Mann, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1777 Tamiami Trl Ste 201, Port Charlotte, FL 33948 Phone: 941-249-4354

Ms Candis L Jackson, LMHC - Medicare Counselor in Port Charlotte, FL