Healthcare Provider Details

I. General information

NPI: 1003647934
Provider Name (Legal Business Name): OPTUM BEHAVIORAL CARE OF COLORADO, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 W 109TH ST
BLOOMINGTON MN
55438-2374
US

IV. Provider business mailing address

11000 OPTUM CIR
EDEN PRAIRIE MN
55344-2503
US

V. Phone/Fax

Practice location:
  • Phone: 612-223-8898
  • Fax:
Mailing address:
  • Phone: 726-217-4995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LESLIE FUCHS
Title or Position: ADMIN CEO
Credential:
Phone: 810-358-1643