Mirissa Jackson, in Cantonment, FL - Medicare Social Worker Provider

Mirissa Jackson, is a medicare enrolled "Social Worker - Clinical" provider in Cantonment, Florida. Her current practice location is 3771 Stefani Rd, Cantonment, Florida. You can reach out to her office (for appointments etc.) via phone at (850) 607-6910.

Mirissa Jackson is licensed to practice in Maryland (license number 25215) 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 1831757905.

Contact Information

	Mirissa Jackson,
	3771 Stefani Rd, Cantonment, FL 32533-7795
	(850) 607-6910
	(850) 607-6932

Map and Direction

Healthcare Provider's Profile

Full Name	Mirissa Jackson
Gender	Female
Speciality	Social Worker - Clinical
Location	3771 Stefani Rd, Cantonment, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1831757905
Provider Enumeration Date: 06/03/2019
Last Update Date: 03/24/2025

Medicare PECOS Information:

PECOS PAC ID: 0547646929
Enrollment ID: I20221010000039

Medical Identifiers

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

Identifier	Type	State	Issuer
1831757905	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	25215 (Maryland)	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. Mirissa Jackson allows following entities to bill medicare on her behalf.

Entity Name	Sondermind Provider Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210908001372

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. Mirissa 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
Mirissa Jackson, 3771 Stefani Rd, Cantonment, FL 32533-7795 Ph: (850) 607-6910	Mirissa Jackson, 3771 Stefani Rd, Cantonment, FL 32533-7795 Ph: (850) 607-6910

Reviews and Comments

Social Worker in Cantonment, FL

Ms. Kathleen Robinson Vail, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1496 Stefani Cir, Cantonment, FL 32533 Phone: 850-494-3083
Lynette Yvonne Bledsoe, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2161 S Highway 97, Cantonment, FL 32533 Phone: 850-712-6901
Amber Nichole Biello-taylor, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1135 Green Hills Rd, Cantonment, FL 32533 Phone: 609-781-2671
Andrea Blair Edgar, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2845 Frederick St, Cantonment, FL 32533 Phone: 850-418-1440
Shelia Massey, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1879 Brentco Rd, Cantonment, FL 32533 Phone: 850-390-1370
Ms. Rebecca Garthwaite, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2328 Trailwood Dr, Cantonment, FL 32533 Phone: 850-384-4862

Mirissa Jackson, - Medicare Clinical Social Worker in Cantonment, FL