Provider Demographics
NPI:1861715427
Name:BEATTY, SHELIA (MHR LPC)
Entity type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:
Last Name:BEATTY
Suffix:
Gender:F
Credentials:MHR LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E APACHE ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-3702
Mailing Address - Country:US
Mailing Address - Phone:918-852-5623
Mailing Address - Fax:918-794-0196
Practice Address - Street 1:240 E APACHE ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-3702
Practice Address - Country:US
Practice Address - Phone:918-852-5623
Practice Address - Fax:918-794-0196
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200289600AMedicaid