Sharon M Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005642 Issued in MO

Practice address

965 Mattox Dr
Sullivan, MO 63080-2365

Phone

(673) 860-6000

Fax

(573) 860-6016

NPI assigned

Nov 10, 2006

Last updated

Apr 11, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MO

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

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Liss and Assoc IncGroup PAC ID 2062461114, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Liss & Assoc., Inc.

  • Mental Health Counselor
  • Saint Louis, MO
  • NPI 1457444598
  Medicare reassignment Care Compare group NPD
• Jay L. Liss, Incorporated

  • Mental Health Counselor
  • Saint Louis, MO
  • NPI 1982777454
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1851462097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "STE. 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "573-860-6000",
            "fax_number": "573-860-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 MATTOX DR",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802365",
            "telephone_number": "673-860-6000",
            "fax_number": "573-860-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHARON",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "005642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Rebecca Hood, LMT
• Hope Ranch of Missouri
• Wei Quan How, MD
• Mary Hulsey, OT
• Yasuo Ishida, M.D.
• Thomas James Jackson, M.D.
• Shelley Jannings, RPH
• Jarco Inc (Strauser Drugs)
• Jarco, Inc. (Strauser Drugs)
• Christopher Lloyd Jeffrey, LCSW

• Clinical Social Worker in Sullivan, MO
• Providers in Sullivan, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.