Healthcare Provider Details

I. General information

NPI: 1063022101
Provider Name (Legal Business Name): OPTUM BEHAVIORAL CARE OF NORTH CAROLINA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2020
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S 5TH ST STE 825
MINNEAPOLIS MN
55402-4200
US

IV. Provider business mailing address

150 S 5TH ST STE 825
MINNEAPOLIS MN
55402-4200
US

V. Phone/Fax

Practice location:
  • Phone: 877-441-0121
  • Fax:
Mailing address:
  • Phone: 877-441-0121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

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