Rosalyn Eloise-nadine Jackson, LPC in Russellville, AR

Rosalyn Eloise-nadine Jackson, LPC is a medicare enrolled "Counselor - Professional" provider in Russellville, Arkansas. Her current practice location is 110 Skyline Dr, Russellville, Arkansas. You can reach out to her office (for appointments etc.) via phone at (479) 967-5570.

Rosalyn Eloise-nadine Jackson is licensed to practice in Arkansas (license number P1601006) 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 1215225438.

Contact Information

	Rosalyn Eloise-nadine Jackson, LPC
	110 Skyline Dr, Russellville, AR 72801-3362
	(479) 967-5570
	(479) 890-5364

Map and Direction

Healthcare Provider's Profile

Full Name	Rosalyn Eloise-nadine Jackson
Gender	Female
Speciality	Counselor - Professional
Location	110 Skyline Dr, Russellville, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1215225438
Provider Enumeration Date: 07/21/2011
Last Update Date: 04/22/2020

Medicare PECOS Information:

PECOS PAC ID: 3678922796
Enrollment ID: I20231213004097

Medical Identifiers

Medical identifiers for Rosalyn Eloise-nadine Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215225438	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	P1601006 (Arkansas)	Secondary
101YP2500X	Counselor - Professional	P1601006 (Arkansas)	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. Rosalyn Eloise-nadine Jackson allows following entities to bill medicare on her behalf.

Entity Name	Counseling Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649381120 PECOS PAC ID: 3173583564 Enrollment ID: O20041011000417

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. Rosalyn Eloise-nadine 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
Rosalyn Eloise-nadine Jackson, LPC 2400 S 48th St, Springdale, AR 72762-6683 Ph: (479) 750-2020	Rosalyn Eloise-nadine Jackson, LPC 110 Skyline Dr, Russellville, AR 72801-3362 Ph: (479) 967-5570

Reviews and Comments

Counselor in Russellville, AR

Megan Roshawn Ford, Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Skyline Dr, Russellville, AR 72801 Phone: 479-967-5570 Fax: 479-890-5364
Raven Cruz-humberto, Counselor Medicare: Not Enrolled in Medicare Practice Location: 700 E Parkway Dr, Russellville, AR 72801 Phone: 866-921-0149 Fax: 479-777-4400
Phillip M Higdon, MS LADAC CCS Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Skyline Drive, Russellville, AR 72801 Phone: 479-968-1298 Fax: 479-968-6053
Mary Conner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 400 Lake Front Dr, Russellville, AR 72802 Phone: 479-567-4744
Mrs. Marilyn Jean Mckown, MHPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 W Main St Ste 100, Russellville, AR 72801 Phone: 479-964-2011
Matthew Waymack, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1610 S Arkansas Ave, Russellville, AR 72801 Phone: 479-967-4673 Fax: 479-967-7140
Theodore Gongola, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3205 W Main St, Russellville, AR 72801 Phone: 479-967-4673 Fax: 479-967-7140

Rosalyn Eloise-nadine Jackson, LPC - Medicare Counselor in Russellville, AR