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

Individual provider Mental Health Counselor · NPI 1861643389

Tracey Ann Jackson, LBSW is a Clinical Social Worker in Greenwood, South Carolina. Qualified in 2009, 17 years ago. Practices with Self Medical Group, a 396-clinician group and accepts Medicare assignment.

Years since qualifying
17
In the registry since
2008
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Practice location Address checks out

1547 Pkwy Ste 100
Greenwood, SC 29646-4081
Phone: (864) 229-7120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1861643389
Entity typeIndividual (Type 1)
GenderFemale
Credentials LBSW
Sole proprietorNo
NPI enumeratedOctober 2, 2008
Last updated in NPPESOctober 2, 2008

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Self Medical Group — 396 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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