| Sshort Counseling Llc | |
|
17482 Highway 4 Jemez Springs NM 87025 | |
| (612) 505-2694 | |
| Not Available |
| Full Name | Sshort Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 17482 Highway 4, Jemez Springs, New Mexico |
| Authorized Official Name and Position | Susanne Annette Short (SOLE OWNER) |
| Authorized Official Contact | 6125052694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sshort Counseling Llc Po Box 573 Jemez Springs NM 87025-0573 Ph: (612) 505-2694 | Sshort Counseling Llc 17482 Highway 4 Jemez Springs NM 87025 Ph: (612) 505-2694 |
| NPI Number | 1558086967 |
|---|---|
| Provider Enumeration Date | 10/07/2022 |
| Last Update Date | 04/19/2023 |
| Certification Date | 04/19/2023 |
| Medicare PECOS PAC ID | 2466817036 |
|---|---|
| Medicare Enrollment ID | O20230518001970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558086967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susanne Short |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639349020 PECOS PAC ID: 7810352481 Enrollment ID: I20230518002563 |
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