OrganizationCarrie F Short(<Unavail>)Social WorkerBehavioral Health & Social Service ProvidersPractice Address6202 S Lewis Ave, Suite A, Tulsa, OK 74136-1099(918) 742-1275PECOS EnrollmentBased on the most recent information from CMS, provider Carrie F Short does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1558621565Provider TypeOrganizationFull NameCarrie F ShortOther Name<Unavail>SubpartNoEnumeration Date5/23/2012Last Updated5/23/2012Contact InformationPractice LocationPractice Address6202 S Lewis Ave, Suite A, Tulsa, OK 74136-1099Phone(918) 742-1275Fax(918) 742-7020Mailing LocationMailing Address6202 S Lewis Ave, Suite A, Tulsa, OK 74136-1099Phone(918) 742-1275Fax(918) 742-7020Authorized OfficialNameShort, Carrie F (Licensed Clinical Social Worker)Phone(918) 742-1275Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense1277OklahomaProvider IdentifiersIDDescriptionIssuerID200199870BDescriptionMedicaidIssuerUnlistedOklahoma