Individual provider · Type 1 NPI

Kristle Jackson

Professional Counselor · Green Lake, WI

NPI number 1780500892 Active

Practice location

571 County Road A
Green Lake, WI 54941-8630

Call (920) 294-4070 Map

Fax (920) 294-4139

Mailing address

227 N Westhaven Dr Apt X206
Oshkosh, WI 54904-7689

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X12345-125 (WI)

Professional Counselor: Definition to come...

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About NPI 1780500892

Kristle Jackson's National Provider Identifier is 1780500892, issued on Jun 24, 2026. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Green Lake, WI. The record was last updated on Jun 24, 2026.