Provider Demographics
NPI:1184864266
Name:OPTIMA BEHAVIORAL HEALTH, INC
Entity Type:Organization
Organization Name:OPTIMA BEHAVIORAL HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHNEIR
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:614-759-5075
Mailing Address - Street 1:81 OUTERBELT ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1548
Mailing Address - Country:US
Mailing Address - Phone:614-759-5075
Mailing Address - Fax:614-759-5079
Practice Address - Street 1:81 OUTERBELT ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1548
Practice Address - Country:US
Practice Address - Phone:614-759-5075
Practice Address - Fax:614-759-5079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002924101YM0800X
OHI5695101YM0800X
OHI00086761041C0700X
OHI00071671041C0700X
OH3540495322084P0800X
OH350912092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSPSW15682Medicare PIN
OHSC05088664Medicare UPIN
OH16603Medicare PIN