JACKIE LEDBETTER (LCSW) – Counselor, NPI 1811217557

JACKIE LEDBETTER (LCSW) is a healthcare provider. based in Edmond, Oklahoma. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 5839 (OK). The NPI Number for JACKIE LEDBETTER (LCSW) is 1811217557

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
JACKIE LEDBETTER (LCSW)
NPI
1811217557
Phone
(405) 378-2727
Address
755 W COVELL RD STE 100
Enumeration Date
4 June 2010
Last Update Date
25 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4053782727
Graduation Year
2013 (13 years ago)
PAC ID
6305275777
Group Practice PAC ID
3476927740
Professional Enrollment ID
I20251030000198
Address ID
OK730032381ED755XXRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness85
Years active:16State licenses:1Digital endpointsOther names

628 CLINICAL SOCIAL WORKER in OK

Provider Addresses for JACKIE LEDBETTER (LCSW)

  • 755 W COVELL RD STE 100

    EDMOND, OK 730032381

    Phone: (405) 378-2727

    Type: Mailing

  • 1222 NW 17TH ST

    OKLAHOMA CITY, OK 731064202

    Phone: (405) 525-3963

    Fax: (405) 525-3963

    Type: Mailing

  • 9500 NE 150TH ST

    JONES, OK 730498601

    Phone: (405) 396-3391

    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: 2025-10-30

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
I20251030000198IClinical Social WorkerOKTBD

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 73003)

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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: 3476927740View full group profile
NameSpecialtyState
Mental Health CounselorOK
Nurse PractitionerOK
Nurse PractitionerOK
Clinical Social WorkerOK
Nurse PractitionerOK
Marriage And Family TherapistOK
Physician AssistantOK
Mental Health CounselorOK
Clinical Social WorkerOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

How do payers reference JACKIE LEDBETTER (LCSW)?
For JACKIE LEDBETTER (LCSW), use NPI 1811217557 as the unique 10-digit identifier.
Active or inactive — what applies to JACKIE LEDBETTER (LCSW)?
You should see JACKIE LEDBETTER (LCSW) as active in CMS-hosted NPPES data.
How would a patient describe JACKIE LEDBETTER (LCSW)'s focus?
For JACKIE LEDBETTER (LCSW), the primary taxonomy reads as Counselor. Clinical services aligned with this taxonomy classification.
Where in Oklahoma is JACKIE LEDBETTER (LCSW) registered?
Use Edmond, Oklahoma as the headline location for JACKIE LEDBETTER (LCSW) here.
When was this NPI issued?
Enumeration for JACKIE LEDBETTER (LCSW) is noted as June 4, 2010 where the registry provides it.

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