Individual provider Active NPI

Shaleta Preaster, LCSW

  • Clinical Social Worker
  • Valdosta, GA
National Provider Identifier
1235086257
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006436 Issued in GA
Practice address
407 Cowart Ave
Valdosta, GA 31602-2635
Phone
(229) 834-1659
Fax
(877) 734-1411
NPI assigned
Mar 11, 2026
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW006436 GA Primary

Addresses

Primary practice location

407 Cowart Ave
Valdosta, GA 31602-2635

Mailing address

407 Cowart Ave
Valdosta, GA 31602-2635
Phone (229) 834-1659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331002609 GA Practitioner - Clinical Social Worker 6002160611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1626 Jeurgens CT
Norcross, GA 30093-2219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006436GAMDClinical Social Worker

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pruitthealth Hospice - ValdostaValdosta, GA, CCN 111571 Hospice W-2 Managing Employee (100%) Jul 16, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1235086257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 COWART AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022635",
            "telephone_number": "229-834-1659",
            "fax_number": "877-734-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 COWART AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022635",
            "telephone_number": "229-834-1659",
            "fax_number": "877-734-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREASTER",
        "first_name": "SHALETA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.