SHANAE JACKSON NPI 1679140404

NPI Information

  • NPI: 1679140404
  • Provider Name: SHANAE JACKSON
  • Classification: Social Worker - 104100000X
  • Entity Type: Individual
  • Address: 4285 N RANCHO DR STE 160
    LAS VEGAS, NV
    ZIP 89130
  • Phone: (702) 835-1922

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NPI Details

Shanae Jackson is a social worker in Las Vegas, NV. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. Shanae Jackson NPI is 1679140404. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4285 N RANCHO DR STE 160
LAS VEGAS, NV
ZIP 89130-456
Phone: (702) 835-1922

The enumeration date for this NPI number is 6/9/2021 and was last updated on 2/14/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial WorkerYes
2374U00000XHome Health Aide1306384219NEVADANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11306384219MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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