| Optum Behavioral Care Of Virginia, Inc. | |
|
9212 N Kelley Ave Ste 200 Oklahoma City OK 73131-2419 | |
| (405) 242-5070 | |
| Not Available |
| Full Name | Optum Behavioral Care Of Virginia, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 9212 N Kelley Ave Ste 200, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Kerry Biscornet (SECRETARY) |
| Authorized Official Contact | 6038542929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum Behavioral Care Of Virginia, Inc. 11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (603) 854-2929 | Optum Behavioral Care Of Virginia, Inc. 9212 N Kelley Ave Ste 200 Oklahoma City OK 73131-2419 Ph: (405) 242-5070 |
| NPI Number | 1134992548 |
|---|---|
| Provider Enumeration Date | 11/07/2023 |
| Last Update Date | 11/07/2023 |
| Certification Date | 11/07/2023 |
| Medicare PECOS PAC ID | 3971945924 |
|---|---|
| Medicare Enrollment ID | O20240530003101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134992548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Felicia Dawn Cummings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235255746 PECOS PAC ID: 9931566809 Enrollment ID: I20230607003925 |
| Provider Name | Amy L Bottomly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922302777 PECOS PAC ID: 2860838182 Enrollment ID: I20240308002908 |
| Provider Name | Haley M Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639434855 PECOS PAC ID: 1355780446 Enrollment ID: I20240423001254 |
| Provider Name | Shelly Denise Mccharen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407112402 PECOS PAC ID: 3870968183 Enrollment ID: I20240610000134 |
| Provider Name | Delana Dawn Ellis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235467416 PECOS PAC ID: 5799141040 Enrollment ID: I20240610000407 |
| Provider Name | Vickie Lynn Staten-ford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811318280 PECOS PAC ID: 3678015336 Enrollment ID: I20240610001316 |
| Provider Name | Ohnre Whaley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598123374 PECOS PAC ID: 0547703738 Enrollment ID: I20240617000315 |
| Provider Name | Fabrice A. Mooney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699809152 PECOS PAC ID: 0840733820 Enrollment ID: I20240618004021 |
| Provider Name | Akemi D Malgonkar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164743910 PECOS PAC ID: 1850834300 Enrollment ID: I20240625001636 |
| Provider Name | Vicki Diana Mcclain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558563759 PECOS PAC ID: 1951844422 Enrollment ID: I20240625002330 |
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