Healthcare Provider Details
I. General information
NPI: 1326810086
Provider Name (Legal Business Name): OPTUM BEHAVIORAL CARE OF DELAWARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/26/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3521 SILVERSIDE RD STE 2D
WILMINGTON DE
19810-4900
US
IV. Provider business mailing address
11000 OPTUM CIR
EDEN PRAIRIE MN
55344-2503
US
V. Phone/Fax
- Phone: 302-268-6105
- Fax:
- Phone: 603-854-2929
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KERRY
BISCORNET
Title or Position: SECRETARY
Credential:
Phone: 603-854-2929