Dr Crystal A Jackson, PHD, LLP | |
3011 W Grand Blvd Ste 413, Detroit, MI 48202-3011 | |
(586) 257-2295 | |
Not Available |
Full Name | Dr Crystal A Jackson |
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Gender | Female |
Speciality | Psychologist - Counseling |
Location | 3011 W Grand Blvd Ste 413, Detroit, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255595948 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC1900X | Psychologist - Counseling | 6301013473 (Michigan) | Primary |
Entity Name | Crystal A. Jackson, Ph.d., Llp, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073124772 PECOS PAC ID: 5799105623 Enrollment ID: O20201015000779 |
Mailing Address | Practice Location Address |
---|---|
Dr Crystal A Jackson, PHD, LLP 212 Woodview Ct, Rochester Hills, MI 48307-4112 Ph: (586) 943-0563 | Dr Crystal A Jackson, PHD, LLP 3011 W Grand Blvd Ste 413, Detroit, MI 48202-3011 Ph: (586) 257-2295 |
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Melissa Moody, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 707 W Milwaukee St, Detroit, MI 48202 Phone: 313-410-4992 | |
Dr. Brittney Devine Walsh, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 17421 Telegraph Rd, Detroit, MI 48219 Phone: 313-255-0900 Fax: 313-255-3465 | |
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