Mary Jo H Shortes, LISW

Individual provider Active NPI Clinical Social Worker · Reserve, NM

NPI 1730312489 · NPPES record last updated Jan 24, 2012

Key facts

NPI
1730312489
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
I-06997 (NM)
Practice address
#1 Foster Road
Reserve, NM 87830
Phone
(575) 533-6456
Fax
(575) 533-6767
NPI assigned
Aug 28, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Border Area Mental Health Services, Inc Past
since Oct 1, 2018
Accepting new patients
New Mexico Health Options Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-06997 NM Yes

Addresses

Primary practice location

#1 Foster Road
Reserve, NM 87830

Mailing address

PO Box 710
Reserve, NM 87830-0710
Phone (575) 533-6456

Other names

  • Mary Jo Heimbigner Former name

Other providers in Reserve, NM

All providers in Reserve, NM · Clinical Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.