Individual provider Active NPI

Jeanie Witcraft Shiau, LCSW

  • Social Worker
  • Johns Creek, GA
National Provider Identifier
1245358852
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
9925 Haynes Bridge Rd Ste 200
Johns Creek, GA 30022-1913
Phone
(678) 667-1673
NPI assigned
Mar 26, 2007
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X TPSW4650 FL
Clinical Social Worker 1041C0700X TLS1180CP SC
Clinical Social Worker 1041C0700X CSW4647 GA
Social Worker 104100000X Primary

Addresses

Primary practice location

9925 Haynes Bridge Rd Ste 200
Johns Creek, GA 30022-1913

Mailing address

12095 Crabapple Lake Dr
Roswell, GA 30076-4260
Phone (678) 809-5835

Other identifiers 2

IdentifierTypeStateIssuer
330739MedicaidGA
1962891853OtherGANPPES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW4647GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psych Solutions Corp Clinical Past Accepting new patients

Organizations & group practices 2

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1245358852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12095 CRABAPPLE LAKE DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764260",
            "telephone_number": "678-809-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 HAYNES BRIDGE RD STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300221913",
            "telephone_number": "678-667-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIAU",
        "first_name": "JEANIE",
        "middle_name": "WITCRAFT",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "TPSW4650",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "TLS1180CP",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW4647",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330739",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1962891853",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.