Healthcare Provider Details

I. General information

NPI: 1730972944
Provider Name (Legal Business Name): OPTUM BEHAVIORAL CARE OF CONNECTICUT, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CENTERVILLE RD STE 103
WARWICK RI
02886-0200
US

IV. Provider business mailing address

1 OPTUM CIR
EDEN PRAIRIE MN
55344-2956
US

V. Phone/Fax

Practice location:
  • Phone: 401-294-0451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JAMIE DUPUY
Title or Position: PRESIDENT
Credential:
Phone: 844-422-5386