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General NPI Number Information
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NPI Number | 1609669902
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Entity Type | Organization
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Legal Business Name | OPTUM BEHAVIORAL CARE OF OHIO, INC.
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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 | 1130 N NIMITZ HWY
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City | HONOLULU
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State | HI
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Zip | 96817-4579
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Country | US
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Telephone | 808-941-9648
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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 | SECRETARY
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Name | KERRY BISCORNET
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Credential |
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Telephone | 603-854-2929
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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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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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