Jackson, Shatara

Jackson, Shatara is an sole proprietor health care provider with primary practice located at 5 Mall Anx , Savannah GA 31406-4738. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Jackson, Shatara can be contacted via phone (912) 495-8887.

Contact Information

Primary practice address
5 Mall Anx Savannah GA 31406-4738
Phone: (912) 495-8887
Fax: (912) 495-8881
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 15612 South Carolina
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW008276 Georgia

Profile Details

NPI number 1033660949
LBN Legal business name Jackson, Shatara
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2016
Last updated Apr 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033660949 NPPES
Massachusetts MEDICAID 110026265E

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