Provider Demographics
NPI:1174059356
Name:SHARED EXPECTATIONS PLLC
Entity type:Organization
Organization Name:SHARED EXPECTATIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:801-644-9626
Mailing Address - Street 1:1480 ORCHARD DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5142
Mailing Address - Country:US
Mailing Address - Phone:801-644-9626
Mailing Address - Fax:801-210-5383
Practice Address - Street 1:1480 ORCHARD DR
Practice Address - Street 2:SUITE 104
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-5142
Practice Address - Country:US
Practice Address - Phone:801-644-9626
Practice Address - Fax:801-210-5383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8906663-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty