| Optum Behavioral Care Of North Carolina, Pc | |
|
5525 Twin Knolls Rd Ste 327 Columbia MD 21045-3207 | |
| (410) 992-9149 | |
| Not Available |
| Full Name | Optum Behavioral Care Of North Carolina, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 5525 Twin Knolls Rd Ste 327, Columbia, Maryland |
| Authorized Official Name and Position | Virginia Marie Steelman (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7045066267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum Behavioral Care Of North Carolina, Pc 11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (704) 506-6267 | Optum Behavioral Care Of North Carolina, Pc 5525 Twin Knolls Rd Ste 327 Columbia MD 21045-3207 Ph: (410) 992-9149 |
| NPI Number | 1518732833 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 11/16/2023 |
| Certification Date | 11/16/2023 |
| Medicare PECOS PAC ID | 5092120030 |
|---|---|
| Medicare Enrollment ID | O20240426003512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518732833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Larry K Grubb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154487072 PECOS PAC ID: 5294914347 Enrollment ID: I20110121000701 |
| Provider Name | Susan H Minsky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053407098 PECOS PAC ID: 9739111717 Enrollment ID: I20110202000281 |
| Provider Name | Roseanne M Middleton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699737346 PECOS PAC ID: 2163459785 Enrollment ID: I20110825000256 |
| Provider Name | Shobhit Singh Negi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629051040 PECOS PAC ID: 8224073879 Enrollment ID: I20160621001895 |
| Provider Name | Lisa C Arge |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457335606 PECOS PAC ID: 8224098884 Enrollment ID: I20170728001125 |
| Provider Name | Mary Anne Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548747710 PECOS PAC ID: 3870843253 Enrollment ID: I20180905002944 |
| Provider Name | Jessica L Kirschensteiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497163786 PECOS PAC ID: 0749532810 Enrollment ID: I20181018000375 |
| Provider Name | Theodore Michener |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144886011 PECOS PAC ID: 5496155517 Enrollment ID: I20210611000051 |
| Provider Name | Heather E Lasslett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790255404 PECOS PAC ID: 7810381118 Enrollment ID: I20220302003022 |
| Provider Name | Olukemi R Omogoke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801365689 PECOS PAC ID: 2365782729 Enrollment ID: I20220309003149 |
| Provider Name | Fernande Tavia Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023162880 PECOS PAC ID: 5496122285 Enrollment ID: I20221108001779 |
| Provider Name | Amy Irene Redman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417688052 PECOS PAC ID: 9739621640 Enrollment ID: I20240606003582 |
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