Provider Demographics
NPI:1053761619
Name:NEASBITT COUNSELING AND PROFESSIONAL DEVELOPMENT, PLLC
Entity type:Organization
Organization Name:NEASBITT COUNSELING AND PROFESSIONAL DEVELOPMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:NEASBITT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LADC
Authorized Official - Phone:405-513-2632
Mailing Address - Street 1:1905 VICTORIA PL
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-3865
Mailing Address - Country:US
Mailing Address - Phone:405-513-2632
Mailing Address - Fax:
Practice Address - Street 1:4900 RICHMOND SQ STE 107
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2043
Practice Address - Country:US
Practice Address - Phone:405-513-2632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2046261QM0801X, 261QM0850X, 261QM0855X, 261QR0405X
OK427261QM0801X, 261QM0850X, 261QM0855X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder