Colleen Acadia Short, LMFT, LMHC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

204896 Issued in TX

Practice address

814 Gilmer Rd Ste 1
Longview, TX 75604-3614

Phone

(903) 692-3724

NPI assigned

Jan 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705104000000",
    "number": "1033531454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 COUNTY ROAD 337",
            "city": "DE BERRY",
            "state": "TX",
            "postal_code": "756392454",
            "telephone_number": "903-692-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 GILMER RD STE 1",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756043614",
            "telephone_number": "903-692-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "COLLEEN",
        "middle_name": "ACADIA",
        "name_prefix": "Ms.",
        "credential": "LMFT, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61185743",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61280351",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15394067",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley M Anderson (New Life Outreach Boarding Homes)
• Shirley M Anderson (New Life Outreach Boarding Homes)
• Billy Dale Shirley, RPH
• Sheena Shirley
• Shorr Hospice Holdings LLC (Prime Care Hospice II)
• Ronald Short II, PT
• Tammi M Short, FNP-C
• Samjhana Shrestha, PMHNP-BC
• Shreveport Vamc
• Snehal Shrivastava, M.D.

• Marriage & Family Therapist in Longview, TX
• Providers in Longview, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.