Provider Demographics
NPI:1700176781
Name:HUGHBANKS, SHARON (LIMHP, LADC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:HUGHBANKS
Suffix:
Gender:F
Credentials:LIMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5217 S 28TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-3402
Mailing Address - Country:US
Mailing Address - Phone:402-715-5454
Mailing Address - Fax:402-715-5452
Practice Address - Street 1:5217 S 28TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-3402
Practice Address - Country:US
Practice Address - Phone:402-715-5454
Practice Address - Fax:402-715-5452
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE867101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)