Healthcare Provider Details

I. General information

NPI: 1952262164
Provider Name (Legal Business Name): OPTUM BEHAVIORAL CARE OF COLORADO, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 S WHITE MOUNTAIN RD STE 3
SHOW LOW AZ
85901-7384
US

IV. Provider business mailing address

2450 S WHITE MOUNTAIN RD STE 3
SHOW LOW AZ
85901-7384
US

V. Phone/Fax

Practice location:
  • Phone: 480-903-5550
  • Fax:
Mailing address:
  • Phone: 480-903-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: AMANDA STACEY BRONSON
Title or Position: DIR GEN MGMT
Credential:
Phone: 978-222-3121