Provider Demographics
NPI:1861703795
Name:BEED, JEFFREY CHARLES (LADC (CANDIDATE))
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:CHARLES
Last Name:BEED
Suffix:
Gender:M
Credentials:LADC (CANDIDATE)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 CREST PL
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-3068
Mailing Address - Country:US
Mailing Address - Phone:405-488-8317
Mailing Address - Fax:
Practice Address - Street 1:229 CREST PLACE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-3068
Practice Address - Country:US
Practice Address - Phone:405-488-8317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)