Organization
SSHORT COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE ANNETTE SHORT MSW, LICSW, LISC (SOLE OWNER)
(612) 505-2694
Entity
Organization
Contact information
Practice address
17482 HIGHWAY 4, JEMEZ SPRINGS, NM 87025
(612) 505-2694
Mailing address
PO BOX 573, JEMEZ SPRINGS, NM 87025-0573
(612) 505-2694
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
04/19/2023
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