Sshort Counseling LLC
Organization Active NPI Clinical Social Worker · Jemez Springs, NM
NPI 1558086967 · NPPES record last updated Apr 19, 2023
Key facts
- NPI
- 1558086967
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- SSHORT COUNSELING LLC
- Practice address
- 17482 Highway 4
Jemez Springs, NM 87025 - Phone
- (612) 505-2694
- NPI assigned
- Oct 7, 2022
- Organization subpart
- No
Authorized official
- Name
- Susanne Annette Short, MSW, LICSW, LISC
- Title
- Sole Owner
- Phone
- (612) 505-2694
Practitioners 1
-
Susanne Annette Short, LICSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230518001970 | NM | Part B Supplier - Clinic/Group Practice | 2466817036 |
Receives reassigned benefits from 1 practitioner Practice locations: Jemez Pueblo, NM |
National Provider Directory
Locations
2136 Ford Pkwy
Ste 5574
Saint Paul, MN 55116
Phone (612) 505-2694
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
17482 Highway 4
Jemez Springs, NM 87025
Mailing address
PO Box 573
Jemez Springs, NM 87025-0573
Phone (612) 505-2694
Other providers in Jemez Springs, NM
- Susan Lucy Miller
- Mountain Crest Counseling, LLC
- Sally Hunter LCSW LLC
- Jessica Sanders
- Susanne Annette Short
- Juliette Sweet
- Amelia Trujillo
All providers in Jemez Springs, NM · Clinical Social Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.