Jennifer Shaw, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW005865 Issued in GA

Practice address

120 E Trinity PL
Decatur, GA 30030-3302

Phone

(404) 378-2300

NPI assigned

May 19, 2015

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 20, 2023 through Dec 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Clarity Counseling Atlanta LLC

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1154832772
  NPD Authorized official

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1780063149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 SHERBROOKE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303451936",
            "telephone_number": "404-378-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E TRINITY PL",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303302",
            "telephone_number": "404-378-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zeev Sharon, M.D.
• Hana Abdullahi Shash, PA-C
• Sharon Shatil, PH.D.
• Shauna H. Mitchell DDS PC
• Adrian Loraine Shaw
• Keith Billings Shaw, DMD
• Rebecca Shaw, LPC
• Sherique Shaw
• Zoe Shaw, APC
• She Heals It LLC

• Clinical Social Worker in Decatur, GA
• Providers in Decatur, 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 May 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.