Healthcare Provider Details

I. General information

NPI: 1457214140
Provider Name (Legal Business Name): SHEKOUH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 S MUSTANG RD STE B
YUKON OK
73099-7314
US

IV. Provider business mailing address

416 S MUSTANG RD STE B
YUKON OK
73099-7314
US

V. Phone/Fax

Practice location:
  • Phone: 251-458-2958
  • Fax:
Mailing address:
  • Phone: 251-458-2958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER C SHEKOUH
Title or Position: OWNER
Credential: LPC-S
Phone: 251-458-2958