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Individual

RICK JAY SHORT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD, LPC

Contact information

Practice address
1000 W NIFONG BLVD BLDG 6, COLUMBIA, MO 65203-5615
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
78181
TX
101YP2500X
Professional Counselor
2023036667
MO
103TC0700X
Clinical Psychologist
Primary
2023038407
MO

Other

Enumeration date
04/16/2019
Last updated
12/14/2023
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