| Grace D. Shortt, Lcsw Acsw Llc | |
|
8101 Vanguard Dr Ste 250 Mechanicsville VA 23111-4707 | |
| (804) 687-0740 | |
| Not Available |
| Full Name | Grace D. Shortt, Lcsw Acsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8101 Vanguard Dr Ste 250, Mechanicsville, Virginia |
| Authorized Official Name and Position | Grace Delk Shortt (OWNER/THERAPIST) |
| Authorized Official Contact | 8046870740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace D. Shortt, Lcsw Acsw Llc 6771 Ships Ln Mechanicsville VA 23111-4590 Ph: (540) 797-8932 | Grace D. Shortt, Lcsw Acsw Llc 8101 Vanguard Dr Ste 250 Mechanicsville VA 23111-4707 Ph: (804) 687-0740 |
| NPI Number | 1427641018 |
|---|---|
| Provider Enumeration Date | 02/16/2021 |
| Last Update Date | 02/26/2021 |
| Certification Date | 02/26/2021 |
| Medicare PECOS PAC ID | 1052720489 |
|---|---|
| Medicare Enrollment ID | O20210514000501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427641018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Grace D Shortt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104053305 PECOS PAC ID: 9739598178 Enrollment ID: I20210514000920 |
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