Active NPI
Krystina Jackson
- Social Worker
- Hamden, CT
National Provider Identifier
1649002569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 8881
- Practice address
- 2911 Dixwell Ave Ste 301
Hamden, CT 06518-3130 - Phone
- (203) 843-5810
- NPI assigned
- Aug 19, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 8881 | CT | |
| Social Worker | 104100000X | 8881 | CT | Primary |
Addresses
Primary practice location
2911 Dixwell Ave Ste 301
Hamden, CT 06518-3130
Mailing address
56 Rockwell Ave
Naugatuck, CT 06770-2708
Phone (860) 230-5011
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1649002569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 ROCKWELL AVE",
"city": "NAUGATUCK",
"state": "CT",
"postal_code": "067702708",
"telephone_number": "860-230-5011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2911 DIXWELL AVE STE 301",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065183130",
"telephone_number": "203-843-5810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KRYSTINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-19",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "8881",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "8881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.