Individual provider Active NPI

Christina Michelle Sticka-Jacobs, ED.S

  • School Psychologist
  • Moorhead, MN
National Provider Identifier
1962351122
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
3601 12TH Ave S
Moorhead, MN 56560-8100
Phone
(218) 284-8481
NPI assigned
Jan 22, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X Primary

Addresses

Primary practice location

3601 12TH Ave S
Moorhead, MN 56560-8100

Mailing address

3601 12TH Ave S
Moorhead, MN 56560-8100
Phone (218) 284-8481

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": "1769040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1962351122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 12TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565608100",
            "telephone_number": "218-284-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 12TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565608100",
            "telephone_number": "218-284-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKA-JACOBS",
        "first_name": "CHRISTINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "ED.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-22",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.