Dr Jack L Shortridge, EDD is a
Marriage & Family Therapist based in N Charleston, South Carolina. Dr Jack L Shortridge is licensed to practice in South Carolina (license number 1213) and his current practice location is
5300 International Blvd, Webster University, N Charleston, South Carolina. He can be reached at his office (for appointments etc.) via phone at
(843) 760-1324.
NPI number for Dr Jack L Shortridge is 1811103468 and his current mailing address is 104 W Shepard Ln, Summerville, South Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1811103468.
Healthcare Provider's Profile
Full Name | Dr Jack L Shortridge |
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Gender | Male |
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Speciality | Marriage & Family Therapist |
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Location | 5300 International Blvd, N Charleston, South Carolina |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1811103468
- Provider Enumeration Date: 05/14/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Jack L Shortridge such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811103468 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC1900X | Psychologist - Counseling | KY-178 (Kentucky) | Primary |
106H00000X | Marriage & Family Therapist | 1213 (South Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack L Shortridge is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Jack L Shortridge, EDD 104 W Shepard Ln, Summerville, SC 29483-4242 Ph: (843) 821-0323 | Dr Jack L Shortridge, EDD 5300 International Blvd, Webster University, N Charleston, SC 29418-6937 Ph: (843) 760-1324 |
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