Healthcare Provider Details

I. General information

NPI: 1407015878
Provider Name (Legal Business Name): SHANDALYN KAREAM DUBLIN M.S, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 N CLASSEN BLVD STE 214
OKLAHOMA CITY OK
73106-6834
US

IV. Provider business mailing address

2209 ALDERHAM AVE
OKLAHOMA CITY OK
73170-3209
US

V. Phone/Fax

Practice location:
  • Phone: 405-601-6710
  • Fax: 405-601-6711
Mailing address:
  • Phone: 405-230-0173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11878
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: