Healthcare Provider Details

I. General information

NPI: 1255241113
Provider Name (Legal Business Name): SHARP MINDS MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14356 COUNTY ROAD 1571
ADA OK
74820-7968
US

IV. Provider business mailing address

14356 COUNTY ROAD 1571
ADA OK
74820-7968
US

V. Phone/Fax

Practice location:
  • Phone: 580-246-4218
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN SHARP
Title or Position: OWNER
Credential: MSN, APRN, PMHNP-BC
Phone: 580-495-7338