Samantha J Jackson, LICSW in Salem, OR - Medicare Social Worker Provider

Samantha J Jackson, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Salem, Oregon. current practice location is 2355 State St Ste 10, Salem, Oregon. You can reach out to office (for appointments etc.) via phone at (541) 577-1657.

Samantha J Jackson is licensed to practice in Minnesota (license number 25126) and also participates in the medicare program. does not accept medicare assignments directly but may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. NPI Number is 1265108484.

Contact Information

	Samantha J Jackson, LICSW
	2355 State St Ste 10, Salem, OR 97301-4541
	(541) 577-1657
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Samantha J Jackson
Gender
Speciality	Social Worker - Clinical
Location	2355 State St Ste 10, Salem, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265108484
Provider Enumeration Date: 08/18/2021
Last Update Date: 05/08/2024

Medicare PECOS Information:

PECOS PAC ID: 1951707850
Enrollment ID: I20220603000742

Medical Identifiers

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

Identifier	Type	State	Issuer
1265108484	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	L14321 (Oregon)	Secondary
1041C0700X	Social Worker - Clinical	25126 (Minnesota)	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. Samantha J Jackson allows following entities to bill medicare on behalf.

Entity Name	Bodhi Education Services, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518602176 PECOS PAC ID: 1254719263 Enrollment ID: O20220603000846

Entity Name	Brightside Medical Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609335660 PECOS PAC ID: 3678948809 Enrollment ID: O20230818003438

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. Samantha J 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
Samantha J Jackson, LICSW 2355 State St Ste 10, Salem, OR 97301-4541 Ph: (541) 577-1657	Samantha J Jackson, LICSW 2355 State St Ste 10, Salem, OR 97301-4541 Ph: (541) 577-1657

Reviews and Comments

Social Worker in Salem, OR

Mr. Jes Dimas, LCSW, LICSW, LSSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 494 State St Ste 270, Salem, OR 97301 Phone: 503-583-2121 Fax: 855-855-4872
John B Milnes, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1645 Liberty St Se, Salem, OR 97302 Phone: 503-585-5328 Fax: 503-588-5327
Mr. Mark Alan Mckinney, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1698 Liberty St Se, Salem, OR 97302 Phone: 503-363-5435
Rachel Seibert, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Northwest Registered Agent Llc #513290-93, 2355 State St, Ste 101, Salem, OR 97301 Phone: 503-388-4196
Keith Nelson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 150 Kingwood Ave Nw, Salem, OR 97304 Phone: 503-588-5816 Fax: 503-588-5803
Kathie L Yelliott, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5125 Skyline Rd S, Salem, OR 97306 Phone: 503-588-5955
Ms. Kathleen Marie Baptiste-mckinney, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1698 Liberty St Se, Salem, OR 97302 Phone: 503-363-5435 Fax: 503-364-7272

Samantha J Jackson, LICSW - Medicare Clinical Social Worker in Salem, OR