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KRISTIN JACKSON
NPI 1972204022
Counselor - Mental Health in Dunkirk, NY

Active since March 15, 2023PECOS Enrolled
186 LAKE SHORE DR W, DUNKIRK, NY 14048(716) 366-7660 Get Directions Write a Review

NPPES record last updated: March 15, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kristin Jackson NPPES

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

KRISTIN JACKSON (NPI 1972204022) is an individual mental health provider in Dunkirk, New York, licensed in New York (P120255) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1972204022
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKRISTIN JACKSON
Location Address186 LAKE SHORE DR WDunkirk, NY 14048-1437
Mailing Address14 Winding WayLakewood, NY 14750-9632 · (585) 610-2469
Phone(716) 366-7660
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateMarch 15, 2023
NPPES CertifiedMarch 15, 2023
✔ NPI 1972204022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · P120255
186 LAKE SHORE DR W, Dunkirk, NY 14048
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kristin Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820598725
PECOS Enrollment IDI20250825002726
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELE MERWIN
Occupational Therapy Assistant
186 LAKE SHORE DR W
DUNKIRK, NY 14048
Chautauqua County (716) 366-6125
SYDNEY SWOGER
Occupational Therapist
186 LAKE SHORE DR W
DUNKIRK, NY 14048
Chautauqua County (716) 661-1541
TARA MARIE WHITFIELD MHC-LP
Counselor (Mental Health)
186 LAKE SHORE DR W
DUNKIRK, NY 14048
Chautauqua County (716) 366-7660
JANICE VOGT
Social Worker
186 LAKE SHORE DR W
DUNKIRK, NY 14048
Chautauqua County (716) 366-6125
KE-KHEE GREENOUGH
Peer Specialist
186 LAKE SHORE DR W
DUNKIRK, NY 14048
Chautauqua County (716) 661-1590
AARON POMERANTZ
Social Worker
186 LAKE SHORE DR W
DUNKIRK, NY 14048
Chautauqua County (716) 366-6125
JORDYN B DOLCE
Speech-Language Pathologist
186 LAKE SHORE DR W
DUNKIRK, NY 14048
Chautauqua County (716) 366-6125
MARY SKUBIS
Registered Nurse
186 LAKE SHORE DR W
DUNKIRK, NY 14048
Chautauqua County (716) 366-6125

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 Kristin Jackson's NPI number?

The NPI number for Kristin Jackson is 1972204022. It was assigned to this individual provider in the NPPES registry on March 15, 2023.

Where is Kristin Jackson located?

Kristin Jackson practices at 186 Lake Shore Dr W, Dunkirk, NY 14048. The listed phone number is (716) 366-7660.

What is Kristin Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kristin Jackson enrolled in Medicare?

Yes. Kristin Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kristin Jackson was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.