Erica Jackson, LCSW

Individual provider Active NPI Clinical Social Worker · Troy, VA

NPI 1538867494 · NPPES record last updated Feb 21, 2023

Key facts

NPI
1538867494
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
310 Ironhound Dr
Troy, VA 22974-4368
Phone
(804) 489-8442
NPI assigned
Feb 20, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Virginia Commonwealth University, School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dominion Behavioral Healthcare (26 clinicians)

Practice addresses (Care Compare)

2301 N Parham Rd
Suite 5
Richmond, VA 23229-3171
Phone (804) 270-1124

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240523001368 VA Practitioner - Clinical Social Worker 8325480213 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Behavioral Healthcare Clinical Current Accepting new patients
Dominion Behavioral Healthcare Current
since May 1, 2024
Accepting new patients

Locations

2301 N Parham Rd
Ste 5
Richmond, VA 23229
Phone (804) 270-1124

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

310 Ironhound Dr
Troy, VA 22974-4368

Mailing address

PO Box 28202
Richmond, VA 23228-0202

Other providers in Troy, VA

All providers in Troy, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.