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General NPI Number Information
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NPI Number | 1861191256
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Entity Type | Individual
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Provider Name | JOHN MATTHEW SHARP LRIC
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Gender | Male
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 1039 S 530 W
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City | PAYSON
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State | UT
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Zip | 84651-3226
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Country | US
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Telephone | 385-200-1083
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Fax | 385-333-7151
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Provider Business Mailing Address
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Address Line | 1039 S 530 W
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City | PAYSON
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State | UT
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Zip | 84651-3226
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Country | US
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Telephone | 757-679-3121
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Fax | 385-333-7151
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0704015675
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License Number State | UT
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