SHAUNA MATTINGLY (LCSW) – Clinical Social Worker, NPI 1619987641

SHAUNA MATTINGLY (LCSW) is a healthcare provider. based in Jesup, Georgia. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. CSW003662 (GA). The NPI Number for SHAUNA MATTINGLY (LCSW) is 1619987641

Main info

Female
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
SHAUNA MATTINGLY (LCSW)
NPI
1619987641
Phone
(912) 286-2423
Address
1520 W CHERRY ST
Enumeration Date
9 August 2006
Last Update Date
25 January 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9125308889
Graduation Year
2002 (24 years ago)
PAC ID
6608876180
Group Practice PAC ID
5890078810
Professional Enrollment ID
I20070106000124
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for SHAUNA MATTINGLY (LCSW)

  • West Cherry Street, Jesup, Wayne County, Georgia, 31545, United States

    JESUP, GA 315450610

    Phone: (912) 286-2423

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-01-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070106000124IClinical Social WorkerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31545)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5890078810View full group profile
NameSpecialtyState
Clinical Social WorkerGA
Clinical Social WorkerGA
Nurse PractitionerGA
Clinical Social WorkerGA

Reviews

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Frequently asked questions

Can I cross-check SHAUNA MATTINGLY (LCSW) using NPI 1619987641?
NPI 1619987641 belongs to SHAUNA MATTINGLY (LCSW); compare other details if you need extra assurance.
Is SHAUNA MATTINGLY (LCSW) shown as active in public data?
Registry records indicate SHAUNA MATTINGLY (LCSW) maintains an active NPI.
What expertise is attributed to SHAUNA MATTINGLY (LCSW)?
SHAUNA MATTINGLY (LCSW)'s specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where in Georgia is SHAUNA MATTINGLY (LCSW) registered?
Use Jesup, Georgia as the headline location for SHAUNA MATTINGLY (LCSW) here.
Can I trust this NPI listing for SHAUNA MATTINGLY (LCSW)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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