Individual provider Active NPI

Staci Short

  • Professional Counselor
  • La Place, LA
National Provider Identifier
1376931501
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC3219 Issued in LA
Practice address
576 Belle Terre Blvd
La Place, LA 70068-1715
Phone
(504) 493-2271
NPI assigned
Dec 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT 1096 LA
Professional Counselor 101YP2500X LPC3219 LA Primary
School Counselor 101YS0200X MFT 1096 LA
Mental Health Counselor 101YM0800X MFT 1096 LA
Professional Counselor 101YP2500X MFT 1096 LA

Addresses

Primary practice location

576 Belle Terre Blvd
La Place, LA 70068-1715

Mailing address

1769 Boulevard de Province Apt E
Baton Rouge, LA 70816-8618

Other identifiers 1

IdentifierTypeStateIssuer
47-2598992MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20240126001392 LA Practitioner - Mental Health Counselor 7810340775 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC3219LAMDProfessional Counselor
MFT 1096LAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Providers for a Healthy Feliciana, Inc CurrentSince Jan 1, 2024 Accepting new patients
Primary Care Providers for a Healthy Feliciana Inc CurrentSince Jan 1, 2024 Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc. Current Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc Past Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc Past Accepting new patients
Primary Care Providers for a Healthy Feliciana Inc Past Accepting new patients
Cognitive Development Center of Baton Rouge Past Accepting new patients
Primary Care Providers for a Healthy Feliciana Inc Past Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc. Past Accepting new patients
Primary Care Providers for a Healthy Feliciana, Inc Past Accepting new patients

Locations

455 E Airport Ave
Baton Rouge, LA 70806
Phone (225) 683-1320

10410 Plank Rd
Clinton, LA 70722
Phone (225) 683-8877

11990 Jackson St
Clinton, LA 70722
Phone (225) 570-6111

28315 S Frost Rd
Livingston, LA 70754
Phone (225) 283-1356

54016 Highway 1062
Loranger, LA 70446
Phone (985) 606-9000

3553 Rosedale Rd
Port Allen, LA 70767
Phone (225) 234-0227

Interoperability endpoints

  • Direct secure messaging: staci.short.p1@direct.rkmprimarycare.nextgenshare.com

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1376931501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 BOULEVARD DE PROVINCE APT E",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 BELLE TERRE BLVD",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700681715",
            "telephone_number": "504-493-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "STACI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-22",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "LA",
            "license": "MFT 1096",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "LPC3219",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "LA",
            "license": "MFT 1096",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "MFT 1096",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "MFT 1096",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-2598992",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Place, LA

Sources for this page

Verify at the official NPI Registry.