Provider Demographics
NPI:1114002102
Name:SHARER-MOHATT, KAREN KAY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:KAY
Last Name:SHARER-MOHATT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SHORT DRIVE
Mailing Address - Street 2:
Mailing Address - City:DACONO
Mailing Address - State:CO
Mailing Address - Zip Code:80514-5040
Mailing Address - Country:US
Mailing Address - Phone:402-432-3629
Mailing Address - Fax:303-200-7218
Practice Address - Street 1:435 SHORT DRIVE
Practice Address - Street 2:
Practice Address - City:DACONO
Practice Address - State:CO
Practice Address - Zip Code:80514-5040
Practice Address - Country:US
Practice Address - Phone:402-432-3629
Practice Address - Fax:303-200-7218
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE445103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47083316526Medicaid
NE08462OtherBCBS PROVIDER ID
NER79866Medicare UPIN
NE47083316526Medicaid