Chelsea R Jackson

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5609-57 Issued in WI

Practice address

345 Milwaukee Ave
Burlington, WI 53105-1228

Phone

(267) 410-0903

NPI assigned

Aug 27, 2026

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1669389250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MILWAUKEE AVE",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 MILWAUKEE AVE",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051228",
            "telephone_number": "267-410-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHELSEA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "5609-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke J Huffman, MA
• Stephanie Ann Hughes, L.AC.
• Fouad Jamal-Ul Husnain, M.D.
• Talha Iqbal
• Mary Itzenheiser
• Patricia Mary Jaglowski, MS SPEECH PATHOLOGY
• Kimberly Jay
• Jedediah Lars Jensen, DO
• Ryan Anthony Johnson
• Denita J Jones, PTA

• Clinical Psychologist in Burlington, WI
• Providers in Burlington, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.

Verify at the official NPI Registry.