Individual provider Active NPI

Tonia D. Short, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1891952560
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2004036975 Issued in MO
Practice address
9213 Kathlyn Dr
Saint Louis, MO 63134-3557
Phone
(314) 398-3781
NPI assigned
May 20, 2008
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2004036975 MO Primary
Clinical Social Worker 1041C0700X 149.020540 IL

Addresses

Primary practice location

9213 Kathlyn Dr
Saint Louis, MO 63134-3557

Mailing address

9213 Kathlyn Dr
Saint Louis, MO 63134-3557
Phone (314) 398-3781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090515000120 MO Practitioner - Clinical Social Worker 3072662352 Reassigns benefits to 1 organization
I20190411000648 IL Practitioner - Clinical Social Worker 3072662352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Live Well Counseling ServicesGroup PAC ID 5991002420, 14 clinicians

Practice addresses (Care Compare)

5010 Rose LN
Coulterville, IL 62237-2746
Phone (618) 317-1537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.020540ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Live Well Counseling Services Clinical CurrentSince Feb 26, 2019 Accepting new patients

Locations

746 Urbanna Dr
Freeburg, IL 62243
Phone (618) 317-1537

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1891952560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9213 KATHLYN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631343557",
            "telephone_number": "314-398-3781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9213 KATHLYN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631343557",
            "telephone_number": "314-398-3781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "TONIA",
        "middle_name": "D.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2004036975",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020540",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.