Russell Neilend Jackson, PHD
NPI 1598426884ActiveIndividual· Psychologist, Group Psychotherapy· Columbia, MO
Psychologist, Group Psychotherapy (PHD) in Columbia, Missouri, licensed in MO, with an NPI issued in January 2022. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1598426884 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Jan 7, 2022 |
| Last updated in NPPES | Sep 29, 2025 |
| Certified by provider | Sep 29, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Group Psychotherapy Primary | 103TP2701X | 2021011992 | MO |
| Psychologist, Counseling | 103TC1900X | 2021011992 | MO |
| Psychologist, Clinical | 103TC0700X | 2021011992 | MO |
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 (MO) |
|---|
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Other Psychologist, Group Psychotherapy providers in Columbia
- 1245357318