Zydet Short

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P015060 Issued in NC

Practice address

7489 Rockfish Rd
Raeford, NC 28376-6131

Phone

(910) 584-6739

NPI assigned

Aug 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Healing Hearts Therapeutic Services, PLLC

  • Community/Behavioral Health Agency
  • Raeford, NC
  • NPI 1801381330

  Clinical

  NPD
• The Counseling Collective, PLLC

  • Mental Health Counselor
  • Wake Forest, NC
  • NPI 1851863609
  NPD (past)

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1386255347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7489 ROCKFISH RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283766131",
            "telephone_number": "910-584-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7489 ROCKFISH RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283766131",
            "telephone_number": "910-584-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "ZYDET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-08-29",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P015060",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharper Images of Fayetteville, Inc
• Nykichia Shamon Shaw, WHNP-BC
• Phyllis Anita Shaw
• Kantrell Deshawn Shelton, LCAS
• William Francis Shilkitus, PAC
• Fatimatou Sidi
• Gustavo Silveira Ribeiro, DMD
• Nicole I Simeone, PHARMD
• Nicole Marie Simon
• Danielle Sines

• Clinical Social Worker in Raeford, NC
• Providers in Raeford, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.