Individual Healthcare Provider
Kristen Marie Jackson, MA, LPCC
Provider's NPPES record last updated: May 28, 2021
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1992385272
- Primary Specialty
- Counselor — Professional
- Practice Location
- Prior Lake, Minnesota
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 7:21 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Counselor
Professional
Behavioral Health & Social Service Providers
Definition to come...
Taxonomy code 101YP2500X
Provider-Reported License Information
- Counselor (Minnesota)
- CC02553
Practice Locations
Practice Location
16180 Hastings Ave Se Ste 205
Prior Lake, Minnesota 55372-9228
Phone: (952) 443-4600
Additional Practice Location
5910 Shingle Creek Pkwy
Brooklyn Center, Minnesota 55430-2322
Phone: (763) 569-5228
Fax: (763) 569-5240
Additional Practice Location
1435 White Oak Dr Ste 200
Chaska, Minnesota 55318-2567
Phone: (952) 443-4600
Fax: (952) 443-4604
Additional Practice Location
1772 Stieger Lake Ln Ste 220
Victoria, Minnesota 55386-7723
Phone: (952) 443-4600
Fax: (952) 443-4604
Additional Practice Location
15265 Carrousel Way Ste 100
Rosemount, Minnesota 55068-1760
Phone: (952) 443-4600
Fax: (952) 443-4604
Record Information
- Enumeration Date
- April 12, 2021
- Provider's NPPES Record Last Updated
- May 28, 2021
- Certification Date
- May 28, 2021
- NPISignal NPPES Dataset
- August 2026
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