Provider Demographics
NPI:1699822981
Name:SOUTHPOINTE FAMILY RESOURCE CENTER, P.C.
Entity Type:Organization
Organization Name:SOUTHPOINTE FAMILY RESOURCE CENTER, P.C.
Other - Org Name:KAREN SHARER-MOHATT, PSYD PC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SHARER-MOHATT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:402-432-3629
Mailing Address - Street 1:435 SHORT DR
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 1:4710 TABLE MESA DR STE B
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-4504
Practice Address - Country:US
Practice Address - Phone:402-432-3629
Practice Address - Fax:303-200-7218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE445103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1114002102OtherINDIVIDUAL NPI
NE27350OtherPTAN
NE098990OtherPTAN
CO1982293734OtherNPI
NE1699822971OtherGROUP NPI