Audrey Lee Jackson, MSW in Ypsilanti, MI - Medicare Social Worker Provider

Audrey Lee Jackson, MSW is a medicare enrolled "Social Worker - Clinical" provider in Ypsilanti, Michigan. Her current practice location is 811 Young St, Ypsilanti, Michigan. You can reach out to her office (for appointments etc.) via phone at (734) 352-9474.

Audrey Lee Jackson is licensed to practice in Michigan (license number 6801105658) 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 1093237943.

Contact Information

	Audrey Lee Jackson, MSW
	811 Young St, Ypsilanti, MI 48198
	(734) 352-9474
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Audrey Lee Jackson
Gender	Female
Speciality	Social Worker - Clinical
Location	811 Young St, Ypsilanti, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1093237943
Provider Enumeration Date: 07/12/2017
Last Update Date: 06/11/2025

Medicare PECOS Information:

PECOS PAC ID: 6204240427
Enrollment ID: I20210129002230

Medical Identifiers

Medical identifiers for Audrey Lee Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093237943	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	6801105658 (Michigan)	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. Audrey Lee Jackson allows following entities to bill medicare on her behalf.

Entity Name	Downriver Mental Health Clinic Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295866135 PECOS PAC ID: 7911995139 Enrollment ID: O20040505000533

Entity Name	Neighborhood Service Organization
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891825808 PECOS PAC ID: 7113907387 Enrollment ID: O20040720001455

Entity Name	Thrive Counseling Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215181300 PECOS PAC ID: 0749458420 Enrollment ID: O20190930001163

Entity Name	Pure Psychiatry Of Michigan Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1831701671 PECOS PAC ID: 1254741283 Enrollment ID: O20201103002311

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. Audrey Lee 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
Audrey Lee Jackson, MSW 811 Young St, Ypsilanti, MI 48198-4021 Ph: (734) 352-9474	Audrey Lee Jackson, MSW 811 Young St, Ypsilanti, MI 48198 Ph: (734) 352-9474

Reviews and Comments

Social Worker in Ypsilanti, MI

Vitalis Im, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3150 Packard Rd, Ypsilanti, MI 48197 Phone: 248-581-8777
Caitlin Corrine Newman, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6633 Stony Creek Rd, Ypsilanti, MI 48197 Phone: 734-485-8725
Jason Francis Schwartz, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6633 Stony Creek Rd, Ypsilanti, MI 48197 Phone: 734-485-8725
Jasmin Ashakih, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2488 Golfside Rd, Ypsilanti, MI 48197 Phone: 734-709-6205
Kia Sweeney, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1740 Cliffs Lndg Apt 202, Ypsilanti, MI 48198 Phone: 313-485-8397
Mrs. Rosalind Mackraz Dieterich, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2900 Packard Rd, Suite 1, Ypsilanti, MI 48197 Phone: 734-528-9703 Fax: 734-572-8866
Matthew Hiller, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 122 S Hamilton St, Ypsilanti, MI 48197 Phone: 615-715-2904

Audrey Lee Jackson, MSW - Medicare Clinical Social Worker in Ypsilanti, MI