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MS. SHENELLE JACKSON MSW, LCSW
NPI 1780167437
Social Worker - Clinical in Oakland, CA

Active since September 10, 2018PECOS Enrolled
3301 E 12TH ST, OAKLAND, CA 94601(510) 269-9030 Get Directions Write a Review

NPPES record last updated: May 4, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 4, 2022, Apr 29, 2022, Feb 11, 2019 and 1 more (4 updates tracked since 2018).

About Ms. Shenelle Jackson Msw, Lcsw NPPES

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

MS. SHENELLE JACKSON MSW, LCSW (NPI 1780167437) is an individual clinical provider in Oakland, California and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780167437
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. SHENELLE JACKSONCredential: MSW, LCSW
Location Address3301 E 12TH STOakland, CA 94601-3424
Mailing Address4142 E Morada Lane, 2202Stockton, CA 95212 · (240) 338-0507
Phone(510) 269-9030
Sole ProprietorYes
Enumeration DateSeptember 10, 2018
Last NPPES UpdateMay 4, 20224 updates tracked since enumeration
NPPES CertifiedMay 4, 2022
✔ NPI 1780167437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
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 ListedCounselorTaxonomy 101Y00000X
3301 E 12TH ST, Oakland, CA 94601
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Shenelle Jackson Msw, 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Shenelle Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Grow Healthcare Group PC
36 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385
Grow Healthcare Group PA
2,584 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, District of Columbia enrollment
  • 1,424 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

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 94601 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 $69.00 – $202.35
Typical copayment $0.00 (range $17.25 – $50.58)
Most-billed visit code NA
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
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 20

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

LEKHA PILLAI
Rehabilitation Practitioner
3301 E 12TH ST
OAKLAND, CA 94601
Alameda County (510) 269-9030
ZULEIKA L LEWIS
Day Training/Habilitation Specialist
3301 E 12TH ST
OAKLAND, CA 94601
Alameda County (510) 467-2445
SHAWNTEE S JAMES
Student in an Organized Health Care Education/Training Program
3301 E 12TH ST
OAKLAND, CA 94601
Alameda County (510) 269-9030
NADRIENNE A PINNOCK
Psychologist
3301 E 12TH ST
OAKLAND, CA 94601
Alameda County (510) 269-9030
ALEXANDER WALDEN
Student in an Organized Health Care Education/Training Program
3301 E 12TH ST, #259
OAKLAND, CA 94601
Alameda County (510) 269-9030
VICTORIA MARIE ALVARADO
Psychologist
3301 E 12TH ST
OAKLAND, CA 94601
Alameda County (510) 269-9030
CHLOE ISABEL VELADOR
Community Health Worker
3301 E 12TH ST
OAKLAND, CA 94601
Alameda County (510) 269-9030
MCKENA I ZAMORANO
Student in an Organized Health Care Education/Training Program
3301 E 12TH ST
OAKLAND, CA 94601
Alameda County (510) 269-9030

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 Shenelle Jackson's NPI number?

The NPI number for Shenelle Jackson is 1780167437. It was assigned to this individual provider in the NPPES registry on September 10, 2018.

Where is Shenelle Jackson located?

Shenelle Jackson practices at 3301 E 12th St, Oakland, CA 94601. The listed phone number is (510) 269-9030.

What is Shenelle Jackson's specialty?

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

Is Shenelle Jackson enrolled in Medicare?

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

Which organizations bill Medicare for Shenelle Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shenelle Jackson reassigns Medicare benefits to 2 organizations: Grow Healthcare Group PC (San Jose, CA) and Grow Healthcare Group PA (Miami, FL). Each 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 Shenelle Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shenelle Jackson was last updated on May 4, 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.