CRYSTAL JACKSON (NPI# 1336560861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336560861 |
| Entity Type | Individual |
| Full Name | CRYSTAL JACKSON |
| Credential | LCASA |
| Practice Address |
579 Pimlico Cir Whitsett NC 27377-8713 |
| Practice Telephone | 3362656934 |
| Mailing Telephone | 3362656934 |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2014-09-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
3432-A | NC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265081384 | Crystal Jackson | Specialist/Technologist | 2426 Cairns Mill Ct, Charlotte, NC 28269-4083 | 2019-09-11 |
| 1487022919 | Crystal Jackson | Behavior Technician | 3205 Shawnee Trl, Alamogordo, NM 88310 | 2015-09-15 |
| 1598140725 | Crystal Jackson | Licensed Practical Nurse | 1585 Holloway Ray Rd, Mc Intyre, GA 31054-2469 | 2015-07-29 |
| 1215288865 | Crystal Jackson | Rehabilitation Practitioner | 1018 Mosskag Ct, North Las Vegas, NV 89032-7696 | 2012-09-23 |
| 1083879837 | Crystal B Jackson | Specialist | 700 Southlake Cir, Youngsville, LA 70592-5671 | 2008-07-22 |
| 1255595948 | Crystal A. Jackson | Psychologist | 3011 W Grand Blvd Ste 413, Detroit, MI 48202-3011 | 2008-07-11 |
| 1659986586 | Crystal E Jackson | Behavior Technician | 6622 N Maroa Ave, Fresno, CA 93704-1209 | 2020-09-08 |
| 1093349367 | Crystal Jackson | Counselor | 422 E Lamar Blvd Ste 108, Arlington, TX 76011-3604 | 2020-02-26 |
| 1437796919 | Crystal Rena Jackson | Counselor | 8220 Castor Ave, Philadelphia, PA 19152-2729 | 2019-12-04 |
| 1255981130 | Crystal L Jackson | Case Manager/Care Coordinator | 1290 Chambers Rd, Aurora, CO 80011-7117 | 2019-09-12 |
| Street Address |
579 PIMLICO CIR |
| City | WHITSETT |
| State | NC |
| Zip Code | 27377-8713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831468156 | Sara Kirkland Huffman | Social Worker | 6602 Maderia Ct, Whitsett, NC 27377 | 2011-12-14 |
| 1003939117 | Graham Shaw Duncan | Family Medicine | 940 Golf House Rd E, Stoney Creek, NC 27377 | 2007-04-06 |
| 1598858920 | Midtown Pharmacy LLC | Pharmacy | 941 Center Crest Dr Ste A, Whitsett, NC 27377 | 2006-09-30 |
| 1750312112 | Billie-lynn D Bean | Nurse Practitioner | 940 Golf House, Court E, Whitsett, NC 27377 | 2006-07-05 |
| 1316902984 | Richard Ira Letvak | Internal Medicine | 940 Golf House Road, Court E, Whitsett, NC 27377 | 2006-04-18 |
| 1629370481 | Innovative Compounding | Pharmacy | 941 Center Crest Dr, Suite D, Whitsett, NC 27377 | 2010-11-30 |
| 1770987380 | United Living, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6815 Seattle Slew Pl, Whitsett, NC 27377-6001 | 2014-10-13 |
| 1588966444 | Innovative Compounding LLC | Pharmacy | 941 Center Crest Dr, Suite D, Whitsett, NC 27377-8001 | 2010-11-29 |
| 1891163457 | Back To Basics Healthcare Pllc | Clinic/Center | 941 Center Crest Dr, Ste C, Whitsett, NC 27377-8001 | 2015-09-11 |
| 1679959464 | Angelique Sheets | Nurse Practitioner | 941 Center Crest Dr, Whitsett, NC 27377-8001 | 2015-08-04 |
| Find all providers in zip 27377 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710710 | Sandra G Inkrote | Counselor | 2599 Lower Moncure Rd, Sanford, NC 27330-9221 | 2020-11-08 |
| 1780285858 | Michelle Tennant | Counselor | 4140 Dudleys Grant Dr Apt C, Winterville, NC 28590-8342 | 2020-11-05 |
| 1043811243 | Ally Health Services LLC | Counselor | 3811 Tarheel Dr Ste 106, Raleigh, NC 27609-7548 | 2020-11-04 |
| 1972104008 | Kay Counseling, Pllc | Counselor | 9635 Southern Pine Blvd Ste 110, Charlotte, NC 28273-5545 | 2020-11-04 |
| 1558962977 | Kayla J Oxendine | Counselor | 86 Threehunts Drive, Pembroke, NC 28372 | 2020-11-03 |
| 1417558834 | Oak Path Counseling Group, Pllc | Counselor | 4285 Highway 24 27 E Ste D, Midland, NC 28107-8505 | 2020-11-03 |
| 1073114666 | Amanda Elaine Richardson | Counselor | 352 W Goldeneye Ln, Sneads Ferry, NC 28460-8096 | 2020-11-02 |
| 1588265144 | Blakeney Behavioral Health LLC | Counselor | 4401 E Independence Blvd Ste 208g, Charlotte, NC 28205-7485 | 2020-11-02 |
| 1689274292 | Transformation Counseling & Consulting | Counselor | 7906 Hogan Dr, Wake Forest, NC 27587-6659 | 2020-11-01 |
| 1679173280 | Rachel Lynn Willms | Counselor | 17 Green Valley Ln, Jackson Springs, NC 27281-9798 | 2020-11-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.