Healthcare Provider Details

I. General information

NPI: 1972084283
Provider Name (Legal Business Name): OPTIMUM COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10410 OSO GRANDE RD NE
ALBUQUERQUE NM
87111-3751
US

IV. Provider business mailing address

10410 OSO GRANDE RD NE
ALBUQUERQUE NM
87111-3751
US

V. Phone/Fax

Practice location:
  • Phone: 505-291-9696
  • Fax:
Mailing address:
  • Phone: 505-291-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: LUSCHA WEEKS
Title or Position: OWNER
Credential: LPCC
Phone: 505-291-9696