Active NPI
Jacques Short II
- Psychologist
- Livonia, MI
National Provider Identifier
1386099687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361008155
- Practice address
- 9559 Middlebelt Rd
Livonia, MI 48150-3009 - Phone
- (269) 459-1818
- NPI assigned
- Apr 25, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6361008155 | MI | Primary |
Addresses
Primary practice location
9559 Middlebelt Rd
Livonia, MI 48150-3009
Mailing address
509 N Eaton St
Albion, MI 49224-1243
Phone (517) 499-8493
Other practice location 1
509 N Eaton St
Albion, MI 49224-1243
Phone (517) 499-8493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6361008155 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1386099687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 N EATON ST",
"city": "ALBION",
"state": "MI",
"postal_code": "492241243",
"telephone_number": "517-499-8493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9559 MIDDLEBELT RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481503009",
"telephone_number": "269-459-1818"
}
],
"practiceLocations": [
{
"address_1": "509 N Eaton St",
"address_purpose": "LOCATION",
"city": "Albion",
"state": "MI",
"postal_code": "492241243",
"country_code": "US",
"telephone_number": "517-499-8493",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHORT",
"first_name": "JACQUES",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-25",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361008155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.