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SHADIASE JACK
NPI 1609299353
Social Worker in Leonardtown, MD

Active since January 31, 2014
41900 FENWICK ST, LEONARDTOWN, MD 20650(301) 475-8860 Get Directions Write a Review

NPPES record last updated: January 31, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shadiase Jack NPPES

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

SHADIASE JACK (NPI 1609299353) is an individual social worker in Leonardtown, Maryland, licensed in Maryland (19632) and active in the NPI registry since January 2014.

NPPES Registry Identity

NPI1609299353
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameSHADIASE JACK
Location Address41900 FENWICK STLeonardtown, MD 20650-3814
Mailing Address41900 Fenwick StLeonardtown, MD 20650-3814 · (301) 475-8860
Phone(301) 475-8860
Sole ProprietorYes
Enumeration DateJanuary 31, 2014
✔ NPI 1609299353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MD · 19632
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
41900 FENWICK ST, Leonardtown, MD 20650
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Other Identifiers 1

Medicaid589561803MD

Other Providers at the Same Location NPPES 20

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

SOUTHERN MARYLAND COMMUNITY NETWORK, INC.
Community Based Residential Treatment Facility, Mental Illness
41900 FENWICK ST, SUITE #5
LEONARDTOWN, MD 20650
St. Mary's County (301) 475-9315
MS. JENNIFER LEIGH CARROLL LCSW-C
Social Worker (Clinical)
41900 FENWICK ST, SUITE #1
LEONARDTOWN, MD 20650
St. Mary's County (301) 475-9660
PSYCHOLOGICAL SERVICES CENTER, LLC
Counselor
41900 FENWICK ST, SUITE 1
LEONARDTOWN, MD 20650
St. Mary's County (301) 475-9660
MELANIE B. LEDIG LCSW-C
Social Worker
41900 FENWICK ST, SUITE 1
LEONARDTOWN, MD 20650
St. Mary's County (301) 475-9660
H JOSEPH MILLER PHD
Psychologist (Cognitive & Behavioral)
41900 FENWICK ST, SUITE 1
LEONARDTOWN, MD 20650
St. Mary's County (301) 475-9660
NATASCHA DILLON
Psychologist (Counseling)
41900 FENWICK ST
LEONARDTOWN, MD 20650
St. Mary's County (301) 475-8860
JASMINE FLEWELLEN LCPC
Counselor (Professional)
41900 FENWICK ST, SUITE 1
LEONARDTOWN, MD 20650
St. Mary's County (301) 475-8860
MAEGAN ODLE
Case Manager/Care Coordinator
41900 FENWICK ST
LEONARDTOWN, MD 20650
St. Mary's County (301) 475-8860

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 Shadiase Jack's NPI number?

The NPI number for Shadiase Jack is 1609299353. It was assigned to this individual provider in the NPPES registry on January 31, 2014.

Where is Shadiase Jack located?

Shadiase Jack practices at 41900 Fenwick St, Leonardtown, MD 20650. The listed phone number is (301) 475-8860.

What is Shadiase Jack's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

When was this NPI record last updated?

The NPPES record for Shadiase Jack was last updated on January 31, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.