Provider Demographics
NPI:1457024515
Name:SHEKOUH, ALEXANDER C (LPC CANDIDATE)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:C
Last Name:SHEKOUH
Suffix:
Gender:M
Credentials:LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 BUENA VIDA LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2185
Mailing Address - Country:US
Mailing Address - Phone:251-458-2958
Mailing Address - Fax:
Practice Address - Street 1:4731 JUDY DR
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3815
Practice Address - Country:US
Practice Address - Phone:405-671-8615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health