Provider Demographics
NPI:1437897261
Name:OPTIMAL HEALING LLC
Entity Type:Organization
Organization Name:OPTIMAL HEALING LLC
Other - Org Name:ASHLEY P. BENSON, LICSW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATIVE PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-398-2929
Mailing Address - Street 1:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-0225
Mailing Address - Country:US
Mailing Address - Phone:413-398-2929
Mailing Address - Fax:
Practice Address - Street 1:184 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-4404
Practice Address - Country:US
Practice Address - Phone:413-398-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA12486843OtherCAQH