Healthcare Provider Details

I. General information

NPI: 1225993595
Provider Name (Legal Business Name): SHARP COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 S 530 W
PAYSON UT
84651-3226
US

IV. Provider business mailing address

1039 S 530 W
PAYSON UT
84651-3226
US

V. Phone/Fax

Practice location:
  • Phone: 385-200-1083
  • Fax:
Mailing address:
  • Phone: 385-200-1083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MIRANDA SHARP
Title or Position: OWNER
Credential:
Phone: 385-200-1083