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General NPI Number Information
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NPI Number | 1023801230
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Entity Type | Organization
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Legal Business Name | OPTUM BEHAVIORAL CARE OF CONNECTICUT, P.C.
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 40 SHATTUCK RD STE 250
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City | ANDOVER
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State | MA
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Zip | 01810-2492
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Country | US
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Telephone | 978-222-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 1 OPTUM CIR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-2956
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMIE DUPUY
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Credential |
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Telephone | 844-422-5386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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