Carolyn R Short

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

702-123 Issued in WI

Practice address

741 N Grand Ave
Suite 302
Waukesha, WI 53186-4820

Phone

(262) 542-3255

NPI assigned

Sep 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Cornerstone Counseling Services

  • Community/Behavioral Health Agency
  • Waukesha, WI
  • NPI 1124105150
  NPD (past)
• Cornerstone Counseling Services, Inc

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  NPD (past)
• Lutheran Social Services of Wisconsin and Upper Michigan, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Janesville, WI
  • NPI 1386719177
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881790368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S57W25446 LOIS LN",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531899605",
            "telephone_number": "262-542-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 N GRAND AVE",
            "address_2": "SUITE 302",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864820",
            "telephone_number": "262-542-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "702-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39225600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy J Shipler
• Eugene Bruce Shoemaker, D.D.S.
• Shopko Stores Operating Co LLC
• Shoptikal LLC
• Shorehaven Behavioral Health Inc
• Karen Short, OTR
• Michael Carl Short, MSW,LCSW
• Evalyn Kate Shulfer, SAC-IT
• Benjamin Sidesky
• Sarfraz Singh Sidhu, M.D.

• Clinical Social Worker in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.