Provider Demographics
NPI:1710239710
Name:ARMSTRONG, SHANEL (MS,LADC UNDER SUPERV)
Entity Type:Individual
Prefix:
First Name:SHANEL
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MS,LADC UNDER SUPERV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 NW 116TH CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7951
Mailing Address - Country:US
Mailing Address - Phone:303-810-0106
Mailing Address - Fax:
Practice Address - Street 1:1301 N MARTIN LUTHER KING AVE
Practice Address - Street 2:STE#101
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-4235
Practice Address - Country:US
Practice Address - Phone:405-424-0007
Practice Address - Fax:405-424-6507
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool