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General NPI Number Information
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NPI Number | 1093604787
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Entity Type | Organization
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Legal Business Name | OPTIMUM BEHAVIORAL HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 116 VERSAILLES BLVD
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City | WEST MONROE
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State | LA
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Zip | 71291-4009
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Country | US
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Telephone | 318-465-5821
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 135
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City | WEST MONROE
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State | LA
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Zip | 71294-0135
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Country | US
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Telephone | 318-314-1415
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Fax |
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Authorized Official
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Title or Position | COO
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Name | ROBERT W WILLILAMS
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Credential |
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Telephone | 318-465-5821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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