Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Susanne Annette Short, LICSW

Individual provider Clinical Social Worker · NPI 1639349020

MS. Susanne Annette Short, LICSW is a Clinical Social Worker in Jemez Springs, New Mexico. Qualified in 1993, 33 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Colorado, Minnesota and New Mexico.

Years since qualifying
33
Licensed in
CO, MN, NM
In the registry since
2008
Specialties on file
3
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

17482 Highway 4
Jemez Springs, NM 87025-8702
Phone: (612) 505-2694
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 2022-0084 (NM)
Clinical Social Worker Taxonomy 1041C0700X · Licence 09928374 (CO)
Clinical Social Worker Taxonomy 1041C0700X · Licence 14543 (MN)

Record details

NPI number1639349020
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedMarch 3, 2008
Last updated in NPPESOctober 3, 2022
Certification dateOctober 3, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Jemez Springs