Provider Demographics
NPI:1265812895
Name:OPTIMAL BEGINNINGS, LLC
Entity type:Organization
Organization Name:OPTIMAL BEGINNINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VISALLI-GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-718-1716
Mailing Address - Street 1:5272 RIVER RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-1405
Mailing Address - Country:US
Mailing Address - Phone:301-718-1716
Mailing Address - Fax:301-718-1766
Practice Address - Street 1:5272 RIVER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1405
Practice Address - Country:US
Practice Address - Phone:301-718-1716
Practice Address - Fax:301-718-1766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103K00000X, 1041C0700X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11314065OtherBACB
TN0145840OtherBACB
MD11210359OtherBACB
MD9641025 00Medicaid
MD1062969OtherBACB
MD1063014OtherBACB
MA1149981OtherBACB
MD173745OtherBACB
MO1107456OtherBACB
MD146026OtherBACB
CA1096383OtherBACB
GA1118018OtherBACB
MD745321Medicaid
MD17943OtherDEPARTMENT OF HEALTH AND MENTAL HYGIENE
MD980005100Medicaid