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NPI Code Detail

MEDICARE: MS. CATHERINE LOUISE SHORT LSW, LCDC III

MEDICARE: MS. CATHERINE LOUISE SHORT LSW, LCDC III
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor161034OH
2104100000XSocial WorkerS.1500163OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609234715
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CATHERINE LOUISE SHORT LSW, LCDC III
Provider Business Mailing Address
First Line : 9 CHESAPEAKE PLZ
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-1003
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9 CHESAPEAKE PLZ
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-1003
Country : US
Telephone Number : 740-270-3286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2016
Last Update Date : 07/23/2024

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