CRYSTAL A. JACKSON, PH.D. , LLP, LLC
NPI 1073124772
Psychologist in Detroit, MI

Active since August 14, 2020
3011 W GRAND BLVD, DETROIT, MI 48202(586) 943-0563 Get Directions Write a Review

NPPES record last updated: January 6, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 6, 2026, Oct 19, 2020, Oct 12, 2020 and 1 more (4 updates tracked since 2020).

About Crystal A. Jackson, Ph.d. , Llp, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL A. JACKSON, PH.D. , LLP, LLC (NPI 1073124772) is a healthcare organization registered as a psychologist in Detroit, Michigan and active in the NPI registry since August 2020. The organization lists Crystal A Jackson, Owner/psychologist, as its authorized official.

NPPES Registry Identity

NPI1073124772
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameCRYSTAL A. JACKSON, PH.D. , LLP, LLC
Location Address3011 W GRAND BLVDDetroit, MI 48202-3096
Mailing Address3011 W Grand Blvd Ste 418Detroit, MI 48202-3011 · (586) 943-0563
Organization SubpartNo
Authorized OfficialCrystal A JacksonOwner/psychologist · (586) 943-0563
Enumeration DateAugust 14, 2020
Last NPPES UpdateJanuary 6, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2026
✔ NPI 1073124772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
3011 W GRAND BLVD, Detroit, MI 48202

Other Names 1

Doing Business AsCrystal A. Jackson, Ph.d. , Llp, Llc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystal A. Jackson, Ph.d. , Llp, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Crystal A. Jackson, Ph.D. , LLP, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1255595948
3011 W GRAND BLVD STE 413
Detroit, MI 48202
(586) 257-2295
✔ PECOS✔ Accepts Medicare0.4 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal A. Jackson, Ph.D. , LLP, LLC's NPI number?

The NPI number for Crystal A. Jackson, Ph.D. , LLP, LLC is 1073124772. It was assigned to this organization in the NPPES registry on August 14, 2020.

Where is Crystal A. Jackson, Ph.D. , LLP, LLC located?

Crystal A. Jackson, Ph.D. , LLP, LLC is located at 3011 W Grand Blvd, Detroit, MI 48202. The listed phone number is (586) 943-0563.

What is Crystal A. Jackson, Ph.D. , LLP, LLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Crystal A. Jackson, Ph.D. , LLP, LLC enrolled in Medicare?

Yes. Crystal A. Jackson, Ph.D. , LLP, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Crystal A. Jackson, Ph.D. , LLP, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Crystal A. Jackson, Ph.D. , LLP, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Crystal A. Jackson, Ph.D. , LLP, LLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Crystal A. Jackson, Ph.D. , LLP, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Crystal A. Jackson, Ph.D. , LLP, LLC was last updated on January 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.