Provider Demographics
NPI:1790163236
Name:SHAE KEEN, LPC
Entity Type:Organization
Organization Name:SHAE KEEN, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-209-1209
Mailing Address - Street 1:880 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:NOBLE
Mailing Address - State:OK
Mailing Address - Zip Code:73068-8760
Mailing Address - Country:US
Mailing Address - Phone:405-209-1209
Mailing Address - Fax:
Practice Address - Street 1:880 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:NOBLE
Practice Address - State:OK
Practice Address - Zip Code:73068-8760
Practice Address - Country:US
Practice Address - Phone:405-209-1209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-17
Last Update Date:2015-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3529251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health