Active NPI
Joan Marie Short, MS, LPC
- Professional Counselor
- Austin, TX
National Provider Identifier
1417985243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 18295
- Practice address
- 56 East Ave
Austin, TX 78701-4323 - Phone
- (512) 454-3571
- Fax
- (512) 703-1390
- NPI assigned
- Jun 29, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 18295 | TX | Primary |
Addresses
Primary practice location
56 East Ave
Austin, TX 78701-4323
Mailing address
1430 Collier St
Austin, TX 78704-2911
Phone (512) 445-7787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1600884 02 | Medicaid | TX |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18295 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1417985243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1430 COLLIER ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787042911",
"telephone_number": "512-445-7787",
"fax_number": "512-440-4059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 EAST AVE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787014323",
"telephone_number": "512-454-3571",
"fax_number": "512-703-1390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "JOAN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "MS, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "18295",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1600884 02",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.