Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Marie Jackson, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1215637301

Mary Marie Jackson, PMHNP-BC is a Nurse Practitioner in Anderson, South Carolina. Qualified in 2022, 4 years ago. Practices with Upstate Wellness Center LLC, a 10-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
4
Licensed in
SC
In the registry since
2023
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

102 Buford Ave Ste A
Anderson, SC 29621-3365
Phone: (864) 280-6551
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 27133 (SC)

Record details

NPI number1215637301
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedMarch 7, 2023
Last updated in NPPESNovember 8, 2024
Certification dateNovember 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Upstate Wellness Center Llc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Anderson