Crystal A. Jackson, PH.D. , LLP, LLC
NPI 1073124772ActiveOrganization· Psychologist· Detroit, MI
Psychologist in Detroit, Michigan, registered in NPPES in August 2020. The authorized official on file is Crystal A. Jackson, PH.D., Owner/Psychologist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1073124772 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 14, 2020 |
| Last updated in NPPES | Jan 6, 2026 |
| Certified by provider | Jan 6, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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