Provider Demographics
NPI:1063469534
Name:SHEFFIELD, KEITH LEROY (MDIV, MS, LPC)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:LEROY
Last Name:SHEFFIELD
Suffix:
Gender:M
Credentials:MDIV, MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S MADISON BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2822
Mailing Address - Country:US
Mailing Address - Phone:918-336-1463
Mailing Address - Fax:918-331-9717
Practice Address - Street 1:245 S MADISON BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2822
Practice Address - Country:US
Practice Address - Phone:918-336-1463
Practice Address - Fax:918-331-9717
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
OK3749101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional