Shauna Mattingly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003662 Issued in GA

Practice address

1520 W Cherry St
Jesup, GA 31545-0610

Phone

(912) 286-2423

NPI assigned

Aug 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Anchored in Wellness, LLC

  • Clinical Social Worker
  • Jesup, GA
  • NPI 1174996847
  Medicare reassignment NPD Authorized official
• Community Health Care Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wrightsville, GA
  • NPI 1932150422
  Medicare reassignment NPD
• Community Health Care Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Sandersville, GA
  • NPI 1184515694
  NPD
• McKinney Community Health Ctr, Inc

  • Federally Qualified Health Center (FQHC)
  • Blackshear, GA
  • NPI 1568623346
  NPD (past)
• Pineland Area Community Services Board

  • Community/Behavioral Health Agency
  • Statesboro, GA
  • NPI 1588735252
  NPD (past)
• Senior Psych Solutions Corp

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1225078629
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1619987641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 W CHERRY ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450610",
            "telephone_number": "912-286-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 W CHERRY ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450610",
            "telephone_number": "912-286-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "SHAUNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnolia Midlands Pain Management
• Jennifer C. Mann-Mackey, LPC
• Mark Byron MD PC
• Shanekia Marsh, NP-C
• Kayla Mathie, FNP-C
• Savannah Grace McDaniel, LAT, ATC
• Tiffany S. McDonald, LPC
• Alan McIntosh
• Me Pivot Holdings, LLC
• Andrea Brooke Meeks

• Clinical Social Worker in Jesup, GA
• Providers in Jesup, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.