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SHATARA JACKSON LCSW
NPI 1033660949
Social Worker - Clinical in Savannah, GA

Active since October 17, 2016PECOS Enrolled
5 MALL ANX, SAVANNAH, GA 31406(912) 495-8887(912) 495-8881 Get Directions Write a Review

NPPES record last updated: April 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 6, 2023, Mar 24, 2023, Nov 26, 2022 and 1 more (4 updates tracked since 2016).

About Shatara Jackson Lcsw NPPES

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

SHATARA JACKSON LCSW (NPI 1033660949) is an individual clinical provider in Savannah, Georgia, licensed in Georgia (CSW008276) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1033660949
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHATARA JACKSONCredential: LCSW
Location Address5 MALL ANXSavannah, GA 31406-4738
Mailing Address50 S Parkwood DrSavannah, GA 31404-5213 · (912) 507-0326
Phone(912) 495-8887
Fax(912) 495-8881
Sole ProprietorYes
Enumeration DateOctober 17, 2016
Last NPPES UpdateApril 6, 20234 updates tracked since enumeration
NPPES CertifiedApril 6, 2023
✔ NPI 1033660949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in GA · CSW008276✔ Licensed in SC · 15612
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.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
5 MALL ANX, Savannah, GA 31406
Open in Google Maps ↗

Secondary Practice Locations 2

Location 16711 Forest Park DrSavannah, GA 31406-2507 · Phone (912) 429-8452
Location 250 S Parkwood DrSavannah, GA 31404-5213 · Phone (912) 507-0326

Other Identifiers 1

Medicaid110026265EMA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shatara Jackson Lcsw 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31406 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 $53.31 – $164.04
Typical copayment $0.00 (range $13.32 – $41.01)
Most-billed visit code NA
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
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.

DR. MILEN RAJESH PATEL DMD
Dentist (General Practice)
5 MALL ANX
SAVANNAH, GA 31406
Chatham County (912) 495-8887
JENNIFER A FORREST FNP-C
Nurse Practitioner (Family)
5 MALL ANX
SAVANNAH, GA 31406
Chatham County (912) 721-6704
VICTOR ALLEN PHARMD
Pharmacist
5 MALL ANX
SAVANNAH, GA 31406
Chatham County (912) 721-6735
AMETHYST WILDER MD
Family Medicine
5 MALL ANX
SAVANNAH, GA 31406
Chatham County (912) 721-8882
J C LEWIS PRIMARY HEALTH CARE CENTER
Pharmacy
5 MALL ANX
SAVANNAH, GA 31406
Chatham County (912) 721-6735
MRS. REGINA SMITH MA
Counselor (Mental Health)
5 MALL ANX
SAVANNAH, GA 31406
Chatham County (912) 495-8887
DR. AMANDA CHRISTINE PUENTES M.D.
Pediatrics
5 MALL ANX
SAVANNAH, GA 31406
Chatham County (912) 495-8887
MRS. KEARRA PETTIGREW APRN, FNP
Nurse Practitioner (Family)
5 MALL ANX
SAVANNAH, GA 31406
Chatham County (912) 495-8887

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 Shatara Jackson's NPI number?

The NPI number for Shatara Jackson is 1033660949. It was assigned to this individual provider in the NPPES registry on October 17, 2016.

Where is Shatara Jackson located?

Shatara Jackson practices at 5 Mall Anx, Savannah, GA 31406. The listed phone number is (912) 495-8887.

What is Shatara Jackson's specialty?

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

Is Shatara Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Shatara Jackson was last updated on April 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.