Provider Demographics
NPI:1922207570
Name:BESHIRS, TISHA LYNE (MCP, LPC-C)
Entity Type:Individual
Prefix:
First Name:TISHA
Middle Name:LYNE
Last Name:BESHIRS
Suffix:
Gender:F
Credentials:MCP, LPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TISHOMINGO
Mailing Address - State:OK
Mailing Address - Zip Code:73460-1732
Mailing Address - Country:US
Mailing Address - Phone:580-371-0433
Mailing Address - Fax:
Practice Address - Street 1:603 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TISHOMINGO
Practice Address - State:OK
Practice Address - Zip Code:73460-1732
Practice Address - Country:US
Practice Address - Phone:580-371-0433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health