Crystal Jackson

Primary specialty

CounselorTaxonomy code 101Y00000X

License

80479 Issued in TX

Practice address

422 E Lamar Blvd Ste 108
Arlington, TX 76011-3604

Phone

(817) 751-7802

Fax

(847) 859-5885

NPI assigned

Feb 26, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Makini Counseling, PLLC

  • Mental Health Counselor
  • Allen, TX
  • NPI 1518696186
  NPD Authorized official
• Progressive Behavioral Health, PLLC

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238
  NPD
• PHC of Buffalo Grove Clinical Psychology

  • Psychologist
  • Vernon Hills, IL
  • NPI 1235430612
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1093349367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORN PKWY STE 235",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611454",
            "telephone_number": "847-868-3435",
            "fax_number": "847-859-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 E LAMAR BLVD STE 108",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760113604",
            "telephone_number": "817-751-7802",
            "fax_number": "847-859-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "80479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Care LLC
• Jackson Elite Professionals, LLC
• Arletra Jackson
• Candace Nicole Jackson, M.ED
• Carol Jackson
• Evelyn Salazar Jackson, MSW, LCSW
• Jacquetta Jackson, LSA
• Jada Elizabeth Jackson, LPC
• Jerry W Jackson
• Kassandra Jackson, BSN

• Counselor in Arlington, TX
• Providers in Arlington, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.