Optimal Living Services, Llc | |
160 Moore Dr Ste 207 Lexington KY 40503-2936 | |
(859) 785-1030 | |
Not Available |
Full Name | Optimal Living Services, Llc |
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Speciality | Counselor |
Location | 160 Moore Dr Ste 207, Lexington, Kentucky |
Authorized Official Name and Position | Richard Louis Wheeler (OWNER) |
Authorized Official Contact | 8593514333 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Optimal Living Services, Llc 410 Darby Creek Rd Apt B Lexington KY 40509-1281 Ph: (859) 351-4333 | Optimal Living Services, Llc 160 Moore Dr Ste 207 Lexington KY 40503-2936 Ph: (859) 785-1030 |
NPI Number | 1831753771 |
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Provider Enumeration Date | 04/25/2019 |
Last Update Date | 10/28/2022 |
Certification Date | 10/28/2022 |
Medicare PECOS PAC ID | 3870933484 |
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Medicare Enrollment ID | O20240430002656 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831753771 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
Provider Name | Richard Wheeler |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1982095212 PECOS PAC ID: 2365882982 Enrollment ID: I20240430003384 |
Provider Name | Lauren Bibby |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1487432563 PECOS PAC ID: 9537509070 Enrollment ID: I20240430003815 |
Provider Name | Jennifer Kirk |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1770900524 PECOS PAC ID: 4981044427 Enrollment ID: I20240430003864 |
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