Crystal A. Jackson, PH.D., LLP
NPI 1255595948ActiveIndividual· Psychologist, Counseling· Detroit, MI
Psychologist, Counseling (PH.D., LLP) in Detroit, Michigan, licensed in MI, with an NPI issued in July 2008. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1255595948 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D., LLP |
| Sole proprietor | Yes |
| NPI issued | Jul 11, 2008 |
| Last updated in NPPES | Oct 13, 2020 |
| Certified by provider | Oct 13, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Counseling Primary | 103TC1900X | 6301013473 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MI) |
|---|
Education and affiliations
| Graduation year | 2006 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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