SAMANTHA RAE JACKSON (LPC) – Counselor, NPI 1245607357

SAMANTHA RAE JACKSON (LPC) is a healthcare provider. based in Akron, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. C.1100378 (OH). The NPI Number for SAMANTHA RAE JACKSON (LPC) is 1245607357

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA RAE JACKSON (LPC)
NPI
1245607357
Phone
(330) 502-2532
Address
41 MARSHALL AVE
Enumeration Date
24 August 2015
Last Update Date
24 August 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4402853568
Graduation Year
2012 (14 years ago)
PAC ID
0941731350
Group Practice PAC ID
6901813922
Professional Enrollment ID
I20241009000423
Address ID
OH440249009CH12557DRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

Provider Addresses for SAMANTHA RAE JACKSON (LPC)

  • 41 MARSHALL AVE

    APT. 1

    AKRON, OH 443031412

    Phone: (330) 502-2532

    Type: Mailing

  • 695 SOUTH ST

    CHARDON, OH 440241474

    Phone: (440) 286-1631

    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: 2024-10-09

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
I20241009000423IMental Health CounselorOHTBD

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 44303)

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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: 6901813922View full group profile
NameSpecialtyState
Mental Health CounselorOH
-OH
Clinical Social WorkerOH
Mental Health CounselorOH
Mental Health CounselorOH
-IL
Mental Health CounselorND
Nurse PractitionerOH
Nurse PractitionerTN
P S Y C H I A T R YOH

Reviews

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Frequently asked questions

Can I verify SAMANTHA RAE JACKSON (LPC) with an NPI only?
You can start verification with NPI 1245607357 for SAMANTHA RAE JACKSON (LPC), then check state licensing separately.
Is SAMANTHA RAE JACKSON (LPC) still practicing?
SAMANTHA RAE JACKSON (LPC) is currently listed as active in the public NPI registry.
What taxonomy line describes SAMANTHA RAE JACKSON (LPC)?
For research purposes, treat SAMANTHA RAE JACKSON (LPC) as Counselor in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for SAMANTHA RAE JACKSON (LPC)?
SAMANTHA RAE JACKSON (LPC)'s geographic hint is Akron, Ohio in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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