Healthcare Provider Details

I. General information

NPI: 1306613880
Provider Name (Legal Business Name): OPTUM BEHAVIORAL CARE OF NORTH CAROLINA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 E MATTHEWS AVE
JONESBORO AR
72401-4347
US

IV. Provider business mailing address

11000 OPTUM CIR
EDEN PRAIRIE MN
55344-2503
US

V. Phone/Fax

Practice location:
  • Phone: 870-972-1268
  • Fax:
Mailing address:
  • Phone: 870-972-1268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA MARIE STEELMAN
Title or Position: SECRETARY
Credential:
Phone: 704-506-6267