Healthcare Provider Details

I. General information

NPI: 1861715427
Provider Name (Legal Business Name): SHELIA BEATTY MHR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E APACHE ST
TULSA OK
74106-3702
US

IV. Provider business mailing address

240 E APACHE ST
TULSA OK
74106-3702
US

V. Phone/Fax

Practice location:
  • Phone: 918-852-5623
  • Fax: 918-794-0196
Mailing address:
  • Phone: 918-852-5623
  • Fax: 918-794-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4305
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: