STEPHANIE SHERELLE JACKSON (LCSW) – Clinical Social Worker, NPI 1003521139

STEPHANIE SHERELLE JACKSON (LCSW) is a healthcare provider. based in Converse, Texas. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 58542 (TX). The NPI Number for STEPHANIE SHERELLE JACKSON (LCSW) is 1003521139

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE SHERELLE JACKSON (LCSW)
NPI
1003521139
Phone
(832) 362-2591
Address
5515 DEVILS GATE UNIT 2
Enumeration Date
23 January 2023
Last Update Date
5 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2103336815
Graduation Year
2009 (17 years ago)
PAC ID
8123483633
Group Practice PAC ID
5193999860
Professional Enrollment ID
I20230504002017
Address ID
TX782223529SA5027XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

2,555 CLINICAL SOCIAL WORKER in TX

Provider Addresses for STEPHANIE SHERELLE JACKSON (LCSW)

  • 5515 DEVILS GATE UNIT 2

    CONVERSE, TX 781092671

    Phone: (832) 362-2591

    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: 2023-05-04

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
I20230504002017IClinical Social WorkerTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour27150$0
90834Psychotherapy, 45 minutes7733$0
90791Psychiatric diagnostic evaluation6766$0
90832Psychotherapy, 30 minutes5327$0
View full utilization report →

Insurance plans in this area (ZIP 78109)

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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: 5193999860View full group profile
NameSpecialtyState
Clinical Social WorkerTX
Mental Health CounselorTX
Mental Health CounselorTX
Clinical Social WorkerMA
Mental Health CounselorTX
Clinical PsychologistTX
Mental Health CounselorTX
-TX
Clinical Social WorkerVA
Clinical Social WorkerTX

Reviews

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Frequently asked questions

Can I use this page to confirm STEPHANIE SHERELLE JACKSON (LCSW)'s NPI?
Yes. STEPHANIE SHERELLE JACKSON (LCSW) is listed with NPI 1003521139 in the public NPI dataset.
Is STEPHANIE SHERELLE JACKSON (LCSW) listed as active for patients and plans?
The listing shows STEPHANIE SHERELLE JACKSON (LCSW) as active in the NPI system.
What is STEPHANIE SHERELLE JACKSON (LCSW) best known for clinically?
Directory data describes STEPHANIE SHERELLE JACKSON (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is STEPHANIE SHERELLE JACKSON (LCSW) based?
STEPHANIE SHERELLE JACKSON (LCSW) is tied to Converse, Texas in the data we show; additional addresses may exist on the full record.
Is the information about STEPHANIE SHERELLE JACKSON (LCSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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