Provider Demographics
NPI:1659642387
Name:SHARP'S COUNSELING & CONSULTING AGENCY
Entity Type:Organization
Organization Name:SHARP'S COUNSELING & CONSULTING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED INDEPENDENT MENTAL HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, CPC, LIMHP
Authorized Official - Phone:402-813-5249
Mailing Address - Street 1:1941 S 42ND ST STE 416-M
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2939
Mailing Address - Country:US
Mailing Address - Phone:402-813-5249
Mailing Address - Fax:402-991-2450
Practice Address - Street 1:1941 S 42ND ST STE 416-M
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2939
Practice Address - Country:US
Practice Address - Phone:402-813-5249
Practice Address - Fax:402-991-2450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE448101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1215009857OtherINDIVIDUAL NPI NUMBER
NE10025521100Medicaid