Crystal R Jackson Healthy Lifestyle LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CRYSTAL R JACKSON HEALTHY LIFESTYLE LLC

Practice address

610 York Rd Ste 400
Jenkintown, PA 19046-2866

Phone

(484) 561-1280

NPI assigned

Apr 15, 2024

Organization subpart

No

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

Authorized official

Name

Crystal Rena Jackson, LPCNPI 1437796919

Title

Professional Mental Health Counseor

Phone

(215) 601-7379

Specialties & licenses 1

Addresses

Other names 1

• Crystal R Jackson Healthy Lifestyle LLC Former legal business name

Practitioners 1

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

• Crystal Rena Jackson, LPC

  • Professional Counselor
  • Philadelphia, PA
  • NPI 1437796919
  NPD Authorized official

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1518711829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 YORK RD STE 400",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462866",
            "telephone_number": "484-561-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 YORK RD STE 400",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462866",
            "telephone_number": "484-561-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL R JACKSON HEALTHY LIFESTYLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "RENA",
        "authorized_official_title_or_position": "PROFESSIONAL MENTAL HEALTH COUNSEOR",
        "authorized_official_telephone_number": "215-601-7379",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal R Jackson Healthy Lifestyle LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Crystal R Jackson Healthy Lifestyle LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gayle Diamond Crespy, PSY.D.
• April Croft- Hill
• Andre Cronmiller
• Yatta Katherine Crosby
• Azuba Samantha Cruz
• Julia Lynn Cuccaro-Green, LPC, BC-DMT
• Geraldine Marie Cutler, P.T,CWS
• Susan E. Cutler, D.D.S.
• Astra Beate Czerny, LPC
• Marta A Dabezies, M.D.

• Professional Counselor in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.