Individual provider Active NPI

Shawn D Hackett, LCSW

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1285786582
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22858 Issued in CA
Practice address
301 Green Street
Suite 14
Greensboro, NC 27401
Phone
(888) 382-7190
NPI assigned
Jan 17, 2007
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C016706 NC
Clinical Social Worker 1041C0700X 22858 CA Primary
Clinical Social Worker 1041C0700X 0904015690 VA

Addresses

Primary practice location

301 Green Street
Suite 14
Greensboro, NC 27401

Mailing address

5060 Shoreham PL Ste 300
San Diego, CA 92122-5976
Phone (877) 840-6956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160614002090 CA Practitioner - Clinical Social Worker 2961589759 Reassigns benefits to 2 organizations
Practice locations: Wildomar, CA
I20250801001055 NC Practitioner - Clinical Social Worker 2961589759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical of New Jersey PCGroup PAC ID 5799141750, 61 clinicians
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

3064 Wake Forest Rd
Suite 1271
Raleigh, NC 27609-7844
Phone (415) 360-3348

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904015690VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical of New Jersey, P.C. CurrentSince Jul 1, 2025 Accepting new patients
Sokyahealth Medical Group PC Clinical CurrentSince Jan 1, 2024 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients
Assurasource LTD Clinical PastSince Apr 10, 2022 Accepting new patients
Darrell Broaddus Psychological Services PC Past Accepting new patients

Locations

2386 Faraday Ave
Ste 110
Carlsbad, CA 92008
Phone (858) 427-5060

4470 W Sunset Blvd
Ste 107
Los Angeles, CA 90027
Phone (323) 701-0371

5060 Shoreham Pl
Ste 330
San Diego, CA 92122
Phone (619) 866-0998

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

3064 Wake Forest Rd
Raleigh, NC 27609
Phone (415) 360-3349

Interoperability endpoints

  • Direct secure messaging: shawn.hackett.p1@direct.sokya.nextgenshare.com

Organizations & group practices 6

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1285786582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 SHOREHAM PL STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225976",
            "telephone_number": "877-840-6956",
            "fax_number": "619-840-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GREEN STREET",
            "address_2": "SUITE 14",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "888-382-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "SHAWN",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016706",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "22858",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.