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General NPI Number Information
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NPI Number | 1972611887
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Entity Type | Individual
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Provider Name | DR. PAUL KEITH SHIELDS
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 5525 E 51ST ST STE 530
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City | TULSA
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State | OK
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Zip | 74135-7461
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Country | US
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Telephone | 918-809-1790
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Fax | 918-728-3025
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Provider Business Mailing Address
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Address Line | 120 N VANCOUVER AVE
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City | TULSA
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State | OK
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Zip | 74127-8443
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Country | US
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Telephone | 918-809-1790
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Fax | 918-728-3025
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 583
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 54
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License Number State | OK
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