Tiffany Nicole Jackson, in Lutz, FL - Medicare Counselor Provider

Tiffany Nicole Jackson, is a medicare enrolled "Counselor - Mental Health" provider in Lutz, Florida. Her current practice location is 21808 State Road 54, Lutz, Florida. You can reach out to her office (for appointments etc.) via phone at (813) 428-6100.

Tiffany Nicole Jackson is licensed to practice in Florida (license number MH16981) 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 1164950630.

Contact Information

	Tiffany Nicole Jackson,
	21808 State Road 54, Lutz, FL 33549-6923
	(813) 428-6100
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Tiffany Nicole Jackson
Gender	Female
Speciality	Counselor - Mental Health
Location	21808 State Road 54, Lutz, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164950630
Provider Enumeration Date: 05/30/2017
Last Update Date: 12/09/2019

Medicare PECOS Information:

PECOS PAC ID: 1759739535
Enrollment ID: I20231205001408

Medical Identifiers

Medical identifiers for Tiffany Nicole Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164950630	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	MH16981 (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. Tiffany Nicole Jackson allows following entities to bill medicare on her behalf.

Entity Name	Wellness Psychological Services, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154794881 PECOS PAC ID: 4587969977 Enrollment ID: O20160223001454

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. Tiffany Nicole 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
Tiffany Nicole Jackson, Po Box 46421, Tampa, FL 33646-0104 Ph: () -	Tiffany Nicole Jackson, 21808 State Road 54, Lutz, FL 33549-6923 Ph: (813) 428-6100

Reviews and Comments

Counselor in Lutz, FL

Brianna Michelle Garcia, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 24758 State Road 54 Unit 101, Lutz, FL 33559 Phone: 401-237-0788
Laura Pizzurro, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4125 Apple Blossom Rd, Lutz, FL 33558 Phone: 561-558-3611
Tennazha Bradley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 17665 Bellavista Loop # 1209, Lutz, FL 33558 Phone: 347-360-2072
Ms. Sushama U. Kirtikar, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 16120 N Florida Ave, Lutz, FL 33549 Phone: 813-264-7114 Fax: 813-961-1388
Kimberly Macgregor, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1515 Michelin Ct, Lutz, FL 33549 Phone: 813-949-3904
Mrs. Amber Lynn Lavoie, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2334 Brenthaven Crossing Ct, Lutz, FL 33558 Phone: 401-339-9968
April Veronica Campbell, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1515 Michelin Ct, Lutz, FL 33549 Phone: 813-949-8946

Tiffany Nicole Jackson, - Medicare Counselor in Lutz, FL