Provider Demographics
NPI:1619664034
Name:SHARPE PSYCHIATRIC SERVICES LLC
Entity Type:Organization
Organization Name:SHARPE PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RODNEY
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:II
Authorized Official - Credentials:NP
Authorized Official - Phone:480-910-4160
Mailing Address - Street 1:PO BOX 72615
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-1027
Mailing Address - Country:US
Mailing Address - Phone:480-910-4160
Mailing Address - Fax:
Practice Address - Street 1:2527 E PARKSIDE LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-7575
Practice Address - Country:US
Practice Address - Phone:425-829-8101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty