CRYSTAL JACKSON LCASA NPI 1336560861

NPI Information

  • NPI: 1336560861
  • Provider Name: CRYSTAL JACKSON, LCASA
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 9008 BROAD RIDGE CT
    CHARLOTTE, NC
    ZIP 28269
  • Phone: (336) 254-8677

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NPI Details

Crystal Jackson, LCASA is a mental health counselor in Charlotte, NC. Crystal Jackson, LCASA NPI is 1336560861. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9008 BROAD RIDGE CT
CHARLOTTE, NC
ZIP 28269-199
Phone: (336) 254-8677

The enumeration date for this NPI number is 12/31/2013 and was last updated on 9/26/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2101YM0800XCounselorMental Health3432-ANORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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