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

Mr. Matthew Jackson

Individual provider Clinical Psychologist · NPI 1952794570

Mr. Matthew Jackson is a Clinical Psychologist in South Bend, Indiana. Qualified in 2015, 11 years ago. Practices with Beacon Medical Group Inc, a 574-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
11
Licensed in
IN
In the registry since
2015
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Practice location Address checks out

714 N Michigan St
South Bend, IN 46601-1035
Phone: (574) 647-7477
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 20042961A (IN)

Record details

NPI number1952794570
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 6, 2015
Last updated in NPPESMay 1, 2023
Certification dateMay 1, 2023
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Beacon Medical Group Inc — 574 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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