Mrs Roberta Marie Jackson, LCSW CASAC-II is a medicare enrolled "Social Worker - Clinical" provider in New York, New York. She graduated from healthcare school in 2013 and has 12 years of diverse experience with area of expertise as Clinical Social Worker. Her current practice location is
105 W 125th St, Front 1 #1042, New York, New York. You can reach out to her office (for appointments etc.) via phone at
(347) 654-4405.
Mrs Roberta Marie Jackson is licensed to practice in New York (license number 088300-01) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1760013353.
Healthcare Provider's Profile
| Full Name | Mrs Roberta Marie Jackson |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 12 Years |
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| Location | 105 W 125th St, New York, New York |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mrs Roberta Marie Jackson graduated from medical school in 2013
NPI Data:
- NPI Number: 1760013353
- Provider Enumeration Date: 01/31/2020
- Last Update Date: 08/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 7719335462
- Enrollment ID: I20231120000558
Medical Identifiers
Medical identifiers for Mrs Roberta Marie Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1760013353 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 35723 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | 088300-01 (New York) | Primary |
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. Mrs Roberta Marie 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 |
Mrs Roberta Marie Jackson, LCSW CASAC-II 105 West 125th St, Front 1 #1042, New York, NY 10027-4444 Ph: (475) 900-6271 | Mrs Roberta Marie Jackson, LCSW CASAC-II 105 W 125th St, Front 1 #1042, New York, NY 10027-4444 Ph: (347) 654-4405 |
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