National Provider Identifier
Gary L Short, LCSW-R
Gary L Short, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Bath, NY and a listed phone number of (607) 776-4151.
Profile Overview
- NPI
- 1164674677
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- October 15, 2008
- Last Updated
- October 15, 2008
Practice Location
- 7634 Campbell Creek RD
- Family Life Ministries
- Bath, NY 14810-7612
Phone: (607) 776-4151
Mailing Address
- 7815 County Route 13
- Bath, NY 14810-7904
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1164674677
- Entity Type
- Individual
- Last Name
- Short
- First Name
- Gary
- Middle Name
- L
- Name Prefix
- Mr.
- Credential
- LCSW-R
- Mailing Street Address
- 7815 County Route 13
- Mailing City
- Bath
- Mailing State
- NY
- Mailing ZIP Code
- 14810-7904
- Mailing Country
- US
- Mailing Phone
- (607) 776-4151
- Mailing Fax
- (607) 776-6929
- Practice Street Address
- 7634 Campbell Creek RD
- Practice Address Line 2
- Family Life Ministries
- Practice City
- Bath
- Practice State
- NY
- Practice ZIP Code
- 14810-7612
- Practice Country
- US
- Practice Phone
- (607) 776-4151
- Practice Fax
- (607) 776-6929
- Enumeration Date
- October 15, 2008
- Last Updated
- October 15, 2008
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)