Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Russell Neilend Jackson, PHD

Individual provider Counseling Psychologist · NPI 1598426884

Russell Neilend Jackson, PHD is a Clinical Psychologist in Columbia, Missouri. Qualified in 2020, 6 years ago. Works from 2 locations. Licensed in Missouri.

Years since qualifying
6
Licensed in
MO
In the registry since
2022
Specialties on file
3
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

414 E Broadway Ste 201A
Columbia, MO 65201-4489
Phone: (515) 460-0047
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 211 S 8th St, Columbia, MO 65201-4868 — (573) 882-4677

Specialties & licences

Group Psychotherapy Psychologist (primary) Taxonomy 103TP2701X · Licence 2021011992 (MO)
Counseling Psychologist Taxonomy 103TC1900X · Licence 2021011992 (MO)
Clinical Psychologist Taxonomy 103TC0700X · Licence 2021011992 (MO)

Record details

NPI number1598426884
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJanuary 7, 2022
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Columbia