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General NPI Number Information
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NPI Number | 1336967561
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Entity Type | Organization
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Legal Business Name | OPTUM BEHAVIORAL CARE OF COLORADO PC
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 3601 MINNESOTA DR STE 575
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City | EDINA
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State | MN
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Zip | 55435-5213
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Country | US
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Telephone | 612-223-8898
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Fax | 612-223-8899
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Provider Business Mailing Address
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Address Line | 11000 OPTUM CIR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-2503
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Country | US
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Telephone | 763-330-4069
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LESLIE FUCHS
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Credential |
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Telephone | 810-358-1643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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