Provider Demographics
NPI:1710177373
Name:MACHOLAN, SHARON ELENA (LCSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ELENA
Last Name:MACHOLAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ELENA
Other - Last Name:KRYGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12211 FREEBOARD DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4462
Mailing Address - Country:US
Mailing Address - Phone:402-659-2391
Mailing Address - Fax:
Practice Address - Street 1:12211 FREEBOARD DR STE 100
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4462
Practice Address - Country:US
Practice Address - Phone:402-659-2391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9681041C0700X
NE1641101YM0800X
NE103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool