Michael Leonard Jackson, PhD, LPCC, CRC, CESP
Counselor in Windsor, CO. Individual provider (NPI-1).
NPI number1104731124
StatusActive
Last updated in NPPESAug 14, 2026
Details
- NPI
- 1104731124
- Entity type
- Individual (NPI-1)
- Name
- Michael Leonard Jackson
- Credential
- PhD, LPCC, CRC, CESP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 14, 2026
- Certification date
- Aug 14, 2026
- Last updated
- Aug 14, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | LPCC.0025257 | CO | Yes |
Practice location
5939 Amerifax DrWindsor, CO 80528-9123
Phone 414-232-3728
Mailing address
5939 Amerifax DrWindsor, CO 80528-9123
Phone 414-232-3728
Is something wrong?
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Other Counselor providers in Windsor, CO
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- Stacia J TavernerNPI 1467635086
All 5 Counselor providers in Windsor · All 678 providers in Windsor
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