MS. AMY JANE MATTESON ZICAFOOSE (LMSW) – Mental Health Counselor, NPI 1114521853

MS. AMY JANE MATTESON ZICAFOOSE (LMSW) is a healthcare provider. based in Jackson, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801115641 (MI). The NPI Number for MS. AMY JANE MATTESON ZICAFOOSE (LMSW) is 1114521853

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
MS. AMY JANE MATTESON ZICAFOOSE (LMSW)
NPI
1114521853
Phone
(517) 914-8619
Address
1100 HATCH RD
Enumeration Date
23 November 2020
Last Update Date
21 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5177822551
Graduation Year
2020 (6 years ago)
PAC ID
6103298021
Group Practice PAC ID
5597781385
Professional Enrollment ID
I20230202000414
Address ID
MI492035052JA3425XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

Provider Addresses for MS. AMY JANE MATTESON ZICAFOOSE (LMSW)

  • 1100 HATCH RD

    JACKSON, MI 492019712

    Phone: (517) 914-8619

    Type: Location

  • 2950 W HOWELL RD

    MASON, MI 488549329

    Phone: (517) 367-0670

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-02-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230202000414IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5597781385View full group profile
NameSpecialtyState
Mental Health CounselorMI
Clinical Social WorkerMI
-MI
Clinical Social WorkerMI
Mental Health CounselorOH
Clinical Social WorkerMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

How is MS. AMY JANE MATTESON ZICAFOOSE (LMSW) identified in CMS data?
CMS-hosted NPPES data lists MS. AMY JANE MATTESON ZICAFOOSE (LMSW) with NPI 1114521853.
Does the file indicate MS. AMY JANE MATTESON ZICAFOOSE (LMSW) is practicing under active NPI?
Directory data currently reports MS. AMY JANE MATTESON ZICAFOOSE (LMSW) as active.
What is MS. AMY JANE MATTESON ZICAFOOSE (LMSW)'s specialty?
The listing groups MS. AMY JANE MATTESON ZICAFOOSE (LMSW) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Does MS. AMY JANE MATTESON ZICAFOOSE (LMSW) list a practice location?
Patients near Jackson, Michigan may find MS. AMY JANE MATTESON ZICAFOOSE (LMSW) in results; validate coverage separately.
Why does MS. AMY JANE MATTESON ZICAFOOSE (LMSW) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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