Provider Demographics
NPI:1851961783
Name:YOUSEY, SHANNON TERESE (MHR)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:TERESE
Last Name:YOUSEY
Suffix:
Gender:F
Credentials:MHR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SW 168TH TER
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-6704
Mailing Address - Country:US
Mailing Address - Phone:405-761-8219
Mailing Address - Fax:
Practice Address - Street 1:200 SW 168TH TER
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-6704
Practice Address - Country:US
Practice Address - Phone:405-761-8219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor