Healthcare Provider Details
I. General information
NPI: 1265207591
Provider Name (Legal Business Name): OPTUM BEHAVIORAL CARE OF NORTH CAROLINA, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2023
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8046 N BROTHER BLVD STE 103
BARTLETT TN
38133-2762
US
IV. Provider business mailing address
11000 OPTUM CIR
EDEN PRAIRIE MN
55344-2503
US
V. Phone/Fax
- Phone: 901-682-6136
- Fax:
- Phone: 901-682-6136
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VIRGINIA
MARIE
STEELMAN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 704-506-6267