Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Shasa Jackson, LCSW, DBH

Individual provider Clinical Social Worker · NPI 1013640036

Dr. Shasa Jackson, LCSW, DBH is a Clinical Social Worker in Avondale, Arizona. Licensed in Arizona. Registered with an NPI since 2022.

Licensed in
AZ
In the registry since
2022
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

950 E Van Buren St
Avondale, AZ 85323-1506
Phone: (623) 344-6860
Fax: (602) 655-9682
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-20522 (AZ)

Record details

NPI number1013640036
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , DBH
Sole proprietorNo
NPI enumeratedJuly 7, 2022
Last updated in NPPESJuly 7, 2022
Certification dateJune 27, 2022

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