MEDICARE: OPTUM BEHAVIORAL CARE OF OHIO, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	101YM0800X	Mental Health Counselor
3	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1609669902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTUM BEHAVIORAL CARE OF OHIO, INC.

Provider Business Mailing Address
First Line	:	1 OPTUM CIR
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-2956
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 HOBRON LN PH 1
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96815-1231
Country	:	US
Telephone Number	:	877-622-0013
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	KERRY BISCORNET
Credential	:
Telephone Number	:	603-854-2929

Provider Enumeration Date	:	05/28/2025
Last Update Date	:	04/08/2026

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