Shannon Jackson, MSW, LICSW, LADC
NPI 1194615336 · Clinical Social Worker · Duluth, MN
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shannon Jackson, MSW, LICSW, LADC is a Clinical Social Worker provider in Duluth, MN (NPI 1194615336).
Provider details
- NPI number
- 1194615336
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- MSW, LICSW, LADC
- Sex
- Female
- Sole proprietor
- No
- License
- 31007 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
6 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (5)
- 40 11th StCloquet, MN 55720-1817Phone: (218) 879-4559Fax: (218) 879-0282
- 1401 East 1st StreetDuluth, MN 55805Phone: (218) 728-4491Fax: (218) 728-4404
- 4720 Burning Tree RdDuluth, MN 55811-2634Phone: (218) 728-4491Fax: (218) 728-4404
- 810 E 4th StDuluth, MN 55805-2147Phone: (218) 728-4491Fax: (218) 728-4404
- 325 11th AveTwo Harbors, MN 55616-1300Phone: (218) 834-5520Fax: (218) 834-4264
Registry dates
- Enumerated
- 2025-07-08
- Last updated
- 2025-07-08
- Certified
- 2025-07-08
Frequently asked questions
- What is Shannon Jackson's NPI number?
- Shannon Jackson's National Provider Identifier (NPI) is 1194615336, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shannon Jackson's specialty?
- Shannon Jackson is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Shannon Jackson located?
- Shannon Jackson's practice location on file with NPPES is 120 W 2nd St, Duluth, MN 55802-2017.
- What is Shannon Jackson's phone number?
- The practice phone number listed in the NPPES registry for Shannon Jackson is (218) 728-4491.
- Does Shannon Jackson accept Medicare?
- Shannon Jackson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shannon Jackson's NPI active?
- Yes — Shannon Jackson's NPI (1194615336) is active in the NPPES registry as of the last update on 2025-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.