Individual
DEVONTE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1710 CARTER RD, LANEXA, VA 23089-5725
(804) 433-9801
Mailing address
1710 CARTER RD, LANEXA, VA 23089-5725
(804) 433-9801
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
Primary
0904015454
VA
Other
Enumeration date
11/20/2017
Last updated
07/23/2026
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