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General NPI Number Information
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NPI Number | 1679286025
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Entity Type | Organization
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Legal Business Name | OPTIMAL MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 12/30/2022
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 3440 MYERS GULCH RD STE 4
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City | KITTREDGE
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State | CO
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Zip | 80457-5049
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Country | US
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Telephone | 719-500-4460
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Fax | 719-403-0203
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Provider Business Mailing Address
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Address Line | PO BOX 16811
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City | COLORADO SPRINGS
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State | CO
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Zip | 80935-6811
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Country | US
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Telephone | 719-500-4460
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KELSEY PILLER
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Credential | LPC, LAC
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Telephone | 719-500-4460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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