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DR. SHASA JACKSON LCSW, DBH
NPI 1013640036
Social Worker - Clinical in Avondale, AZ

Active since July 07, 2022PECOS Enrolled
950 E VAN BUREN ST, AVONDALE, AZ 85323(623) 344-6860(602) 655-9682 Get Directions Write a Review

NPPES record last updated: July 7, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Shasa Jackson Lcsw, Dbh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHASA JACKSON LCSW, DBH (NPI 1013640036) is an individual clinical provider in Avondale, Arizona, licensed in Arizona (LCSW-20522) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013640036
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameDR. SHASA JACKSONCredential: LCSW, DBH
Location Address950 E VAN BUREN STAvondale, AZ 85323-1506
Mailing Address2619 E. RooseveltPhoenix, AZ 85008
Phone(623) 344-6860
Fax(602) 655-9682
Sole ProprietorNo
Enumeration DateJuly 7, 2022
NPPES CertifiedJune 27, 2022
✔ NPI 1013640036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in AZ · LCSW-20522
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
950 E VAN BUREN ST, Avondale, AZ 85323
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Antidote Health Plan of Arizona, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shasa Jackson Lcsw, Dbh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shasa Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Maricopa County Special Health Care District
Same address
Adult Mental Health
950 E VAN BUREN ST
Avondale, AZ 85323
  • Reassigned Medicare billing, Arizona enrollment
  • 285 clinicians in this Medicare group
NPI 1043679327 (602) 344-2520

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85323 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $55.44 – $168.60
Typical copayment $0.00 (range $13.86 – $42.15)
Most-billed visit code NA
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTIANA HINES
Counselor (Mental Health)
950 E VAN BUREN ST
AVONDALE, AZ 85323
Maricopa County (623) 687-1199
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Clinic/Center (Adult Mental Health)
950 E VAN BUREN ST
AVONDALE, AZ 85323
Maricopa County (602) 344-2520
CORY JAY NIELSEN
Psychiatry & Neurology (Psychiatry)
950 E VAN BUREN ST
AVONDALE, AZ 85323
Maricopa County (833) 855-9973
MELISSA VILLAMOR BALLECER D.D.S.
Dentist (General Practice)
950 E VAN BUREN ST
AVONDALE, AZ 85323
Maricopa County (623) 344-6809
GABRIEL MURILLO NADER M.D.
Family Medicine
950 E VAN BUREN ST
AVONDALE, AZ 85323
Maricopa County (833) 855-9973
SHANNON YEE DO
Family Medicine
950 E VAN BUREN ST
AVONDALE, AZ 85323
Maricopa County (833) 855-9973
CINTHIA L. BERNAL L.P.C.
Counselor (Mental Health)
950 E VAN BUREN ST
AVONDALE, AZ 85323
Maricopa County (623) 344-6800
DR. GOSHTASB JAVDAN M.D.
Family Medicine
950 E VAN BUREN ST
AVONDALE, AZ 85323
Maricopa County (623) 344-6800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shasa Jackson's NPI number?

The NPI number for Shasa Jackson is 1013640036. It was assigned to this individual provider in the NPPES registry on July 7, 2022.

Where is Shasa Jackson located?

Shasa Jackson practices at 950 E Van Buren St, Avondale, AZ 85323. The listed phone number is (623) 344-6860.

What is Shasa Jackson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Shasa Jackson enrolled in Medicare?

Yes. Shasa Jackson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shasa Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shasa Jackson reassigns Medicare benefits to Maricopa County Special Health Care District (Avondale, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shasa Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shasa Jackson accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona, Inc and 3 other insurers list Shasa Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shasa Jackson was last updated on July 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.