Shana Oniella Jackson, LCSW is a
Social Worker - Clinical based in Chicago, Illinois. Shana Oniella Jackson is licensed to practice in Illinois (license number 149020734) and her current practice location is
2820 W 84th St, Chicago, Illinois. She can be reached at her office (for appointments etc.) via phone at
(312) 752-7892.
NPI number for Shana Oniella Jackson is 1225316581 and her current mailing address is 2820 W 84th St, Chicago, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1225316581.
Healthcare Provider's Profile
| Full Name | Shana Oniella Jackson |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 2820 W 84th St, Chicago, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1225316581
- Provider Enumeration Date: 08/03/2011
- Last Update Date: 03/09/2022
Medical Identifiers
Medical identifiers for Shana Oniella Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225316581 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 94269 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW16838 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6801107893 (Michigan) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149020734 (Illinois) | Primary |
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. Shana Oniella Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shana Oniella Jackson, LCSW
2820 W 84th St,
Chicago, IL 60652-3814
Ph: (312) 752-7892 | Shana Oniella Jackson, LCSW
2820 W 84th St,
Chicago, IL 60652-3814
Ph: (312) 752-7892 |
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