Talia Amo Jackson, PSYD, LP
NPI 1730260902ActiveIndividual· Psychologist· Mpls, MN
Psychologist (PSYD, LP) in Mpls, Minnesota, licensed in MN, with an NPI issued in October 2006.
Overview
| NPI | 1730260902 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD, LP |
| Sole proprietor | Yes |
| NPI issued | Oct 17, 2006 |
| Last updated in NPPES | Feb 12, 2026 |
| Certified by provider | Feb 12, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | LP4738 | MN |
| Psychologist, Clinical | 103TC0700X | LP4738 | MN |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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