Active NPI
Kristal Jackson, LPC
- Professional Counselor
- Richmond, TX
National Provider Identifier
1437721032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 74558
- Practice address
- 7811 Pacific Spring LN
Richmond, TX 77407-4031 - Phone
- (281) 704-1741
- NPI assigned
- Jul 13, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 74558 | TX | Primary |
Addresses
Primary practice location
7811 Pacific Spring LN
Richmond, TX 77407-4031
Mailing address
5614 W Grand Pkwy S Ste 102
Richmond, TX 77406-5820
Phone (281) 764-9816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74558 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1437721032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5614 W GRAND PKWY S STE 102",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774065820",
"telephone_number": "281-764-9816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7811 PACIFIC SPRING LN",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774074031",
"telephone_number": "281-704-1741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KRISTAL",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-13",
"last_updated": "2021-07-13",
"certification_date": "2021-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "74558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.