Provider Demographics
NPI:1194190868
Name:FAMILY DYNAMICS
Entity Type:Organization
Organization Name:FAMILY DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:KRYGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:402-659-2391
Mailing Address - Street 1:17021 LAKESIDE HILLS PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2390
Mailing Address - Country:US
Mailing Address - Phone:402-800-6006
Mailing Address - Fax:402-333-0302
Practice Address - Street 1:17021 LAKESIDE HILLS PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2390
Practice Address - Country:US
Practice Address - Phone:402-800-6006
Practice Address - Fax:402-333-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty