Individual provider Active NPI

Tiffany Short

  • Clinical Social Worker
  • Louisa, KY
National Provider Identifier
1013433119
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
256593 Issued in KY
Practice address
125 S Main Cross St
Louisa, KY 41230-1065
Phone
(606) 638-0938
NPI assigned
Aug 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 256593 KY Primary
Counselor 101Y00000X

Addresses

Primary practice location

125 S Main Cross St
Louisa, KY 41230-1065

Mailing address

125 S Main Cross St
Louisa, KY 41230-1065
Phone (606) 638-0938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230925001941 KY Practitioner - Clinical Social Worker 6002260072 Reassigns benefits to 2 organizations
I20250421000301 WV Practitioner - Clinical Social Worker 6002260072 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Recover Together, Inc. CurrentSince Jan 27, 2025 Accepting new patients
Kentucky Counseling Center, LLC Counselor CurrentSince Jul 17, 2023 Accepting new patients
Pioneer Health Group LLC Past Accepting new patients

Locations

3070 104th St
#100
Urbandale, IA 50322

937 29th St
Ste A
Ashland, KY 41101
Phone (859) 429-2026

277 Roy Campbell Dr
Hazard, KY 41701
Phone (606) 435-0888

1169 Eastern Pkwy
Ste 3328
Louisville, KY 40217
Phone (205) 914-2526

111 S Bedford St
Ste 205
Burlington, MA 01803
Phone (512) 439-3547

4421 Emerson Ave
Ste 205
Parkersburg, WV 26104
Phone (304) 693-6096

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1013433119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "TIFFANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2024-01-17",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256593",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisa, KY

Sources for this page

Verify at the official NPI Registry.