Healthcare Provider Details

I. General information

NPI: 1881565794
Provider Name (Legal Business Name): OPTIMAL HEALING INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 GARDEN AVE STE 215
EUGENE OR
97403-1934
US

IV. Provider business mailing address

PO BOX 7022
SPRINGFIELD OR
97475-0001
US

V. Phone/Fax

Practice location:
  • Phone: 541-968-4325
  • Fax:
Mailing address:
  • Phone: 541-968-4325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MATT CURSON
Title or Position: OFFICE MANAGER
Credential: BA
Phone: 541-285-4006