Shannon L. Jackson, MSW, LICSW, LADC
NPI 1194615336ActiveIndividual· Social Worker, Clinical· Duluth, MN
Social Worker, Clinical (MSW, LICSW, LADC) with Human Development Center, practicing in Duluth, Minnesota. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1194615336 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MSW, LICSW, LADC |
| Sole proprietor | No |
| NPI issued | Jul 8, 2025 |
| Last updated in NPPES | Jul 8, 2025 |
| Certified by provider | Jul 8, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 31007 | MN |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 304733 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MN) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Human Development CenterTwo Harbors, MN · 35 clinicians
Other Social Worker, Clinical providers in Duluth
- 1770296873
- 1669087797
- 1700094315
- 1578372454
- 1437035771
- 1497111686
- 1063915239
- 1487476834
- 1649783697
- 1033661582
- 1457718744
- 1669261566