Ms Shenelle Jackson, MSW, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Oakland, California. She graduated from healthcare school in 2011 and has 14 years of diverse experience with area of expertise as Clinical Social Worker. Her current practice location is
3301 E 12th St, Oakland, California. You can reach out to her office (for appointments etc.) via phone at
(510) 269-9030.
Ms Shenelle Jackson is licensed to practice in California (license number ) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1780167437.
Healthcare Provider's Profile
| Full Name | Ms Shenelle Jackson |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 14 Years |
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| Location | 3301 E 12th St, Oakland, California |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ms Shenelle Jackson graduated from medical school in 2011
NPI Data:
- NPI Number: 1780167437
- Provider Enumeration Date: 09/10/2018
- Last Update Date: 05/04/2022
Medicare PECOS Information:
- PECOS PAC ID: 1355865684
- Enrollment ID: I20250409002467
Medical Identifiers
Medical identifiers for Ms Shenelle Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780167437 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Shenelle Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154994846
PECOS PAC ID: 1850774746
Enrollment ID: O20220809004080 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Shenelle Jackson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Shenelle Jackson, MSW, LCSW
4142 E Morada Lane, 2202,
Stockton, CA 95212
Ph: (240) 338-0507 | Ms Shenelle Jackson, MSW, LCSW
3301 E 12th St,
Oakland, CA 94601-3424
Ph: (510) 269-9030 |
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