Healthcare Provider Details

I. General information

NPI: 1619895612
Provider Name (Legal Business Name): OPTIMAL MENTAL HEALTH AND WELLNESS GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 GATE PKWY BLDG 100
JACKSONVILLE FL
32256-0830
US

IV. Provider business mailing address

5011 GATE PKWY BLDG 100
JACKSONVILLE FL
32256-0830
US

V. Phone/Fax

Practice location:
  • Phone: 877-296-7846
  • Fax: 470-222-2746
Mailing address:
  • Phone: 877-296-7846
  • Fax: 470-222-2746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. ARLENE DENISE JOHNSON
Title or Position: THE CHIEF EXECUTIVE OFFICER
Credential: PMHNP-BC
Phone: 470-866-7796