Individual provider Active NPI

Emma L Short, LPC, CSOTP

  • Professional Counselor
  • South Hill, VA
National Provider Identifier
1124216577
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701003580 Issued in VA
Practice address
514 E Atlantic St
South Hill, VA 23970-2704
Phone
(434) 949-6360
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 0812000550 VA
Professional Counselor 101YP2500X 0701003580 VA Primary

Addresses

Primary practice location

514 E Atlantic St
South Hill, VA 23970-2704

Mailing address

PO Box 211
Alberta, VA 23821-0211
Phone (434) 949-6360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240307001537 OK Practitioner - Mental Health Counselor 9436398468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9201 State Hwy 17
Elgin, OK 73538-4517
Phone (580) 492-4604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0812000550VAMDCounselor
0701003580VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Meherrin River Counseling Services Counselor CurrentSince Jun 1, 2018 Accepting new patients

Locations

9201 State Highway 17
Elgin, OK 73538
Phone (580) 492-4604

Organizations & group practices 1

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": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1124216577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211",
            "city": "ALBERTA",
            "state": "VA",
            "postal_code": "238210211",
            "telephone_number": "434-949-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 E ATLANTIC ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239702704",
            "telephone_number": "434-949-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "EMMA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LPC, CSOTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0812000550",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Hill, VA

Sources for this page

Verify at the official NPI Registry.