Shirley Joyce Beckenhauer, LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Oklahoma City, OK

NPI 1982826673 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1982826673
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
168 (OK)
Practice address
5208 Classen Cir
Oklahoma City, OK 73118-4429
Phone
(405) 810-1766
Fax
(405) 810-0331
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
168OKMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 168 OK Yes

Addresses

Primary practice location

5208 Classen Cir
Oklahoma City, OK 73118-4429

Mailing address

301 W I 240 Service Rd
Oklahoma City, OK 73139-7701
Phone (405) 604-9644

Other identifiers

IdentifierTypeStateIssuer
168OtherOKLICENSED ALCOHOL AND DRUG

Other providers in Oklahoma City, OK

All providers in Oklahoma City, OK · Addiction (Substance Use Disorder) Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.