Sshort Counseling Llc | |
17482 Highway 4 Jemez Springs NM 87025 | |
(612) 505-2694 | |
Not Available |
Full Name | Sshort Counseling Llc |
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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 |
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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 |
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Provider Enumeration Date | 10/07/2022 |
Last Update Date | 04/19/2023 |
Certification Date | 04/19/2023 |
Medicare PECOS PAC ID | 2466817036 |
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Medicare Enrollment ID | O20230503003451 |
Identifier | Type | State | Issuer |
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1558086967 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Susanne Short |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1639349020 PECOS PAC ID: 7810352481 Enrollment ID: I20230503003491 |
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