Organization Active NPI

Jackson Therapy Collective (Formerly Talia Jackson Psychotherapy Services)

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1134068836
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
JACKSON THERAPY COLLECTIVE (FORMERLY TALIA JACKSON PSYCHOTHERAPY SERVICES)
Practice address
2600 Wayzata Blvd
Minneapolis, MN 55405-2123
Phone
(612) 444-1745
Fax
(612) 484-4557
NPI assigned
Mar 26, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Dr. Talia Amo Jackson, PSY.D., LPNPI 1730260902
Title
Licensed Psychologist, Group Owner
Phone
(612) 444-1745

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2600 Wayzata Blvd
Minneapolis, MN 55405-2123

Mailing address

2600 Wayzata Blvd
Minneapolis, MN 55405-2123
Phone (612) 444-1745

National Provider Directory

National Provider Directory
Tax ID family
Jackson Therapy Collective Formerly Talia Jackson Psychotherapy Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2600 Wayzata Blvd
Minneapolis, MN 55405
Phone (612) 444-1745

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1774483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1134068836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052123",
            "telephone_number": "612-444-1745",
            "fax_number": "612-484-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052123",
            "telephone_number": "612-444-1745",
            "fax_number": "612-484-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON THERAPY COLLECTIVE (FORMERLY TALIA JACKSON PSYCHOTHERAPY SERVICES)",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-26",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TALIA",
        "authorized_official_middle_name": "AMO",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST, GROUP OWNER",
        "authorized_official_telephone_number": "612-444-1745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.