| Optum Behavioral Care Of Virginia, Inc. | |
|
1110 Montlimar Dr Ste 500 Mobile AL 36609-1794 | |
| (251) 662-9466 | |
| (833) 449-5269 |
| Full Name | Optum Behavioral Care Of Virginia, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1110 Montlimar Dr Ste 500, Mobile, Alabama |
| Authorized Official Name and Position | Kerry Biscornet (SECRETARY) |
| Authorized Official Contact | 2563252388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum Behavioral Care Of Virginia, Inc. 11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (603) 854-2929 | Optum Behavioral Care Of Virginia, Inc. 1110 Montlimar Dr Ste 500 Mobile AL 36609-1794 Ph: (251) 662-9466 |
| NPI Number | 1851164271 |
|---|---|
| Provider Enumeration Date | 11/07/2023 |
| Last Update Date | 06/26/2024 |
| Certification Date | 06/26/2024 |
| Medicare PECOS PAC ID | 3971945924 |
|---|---|
| Medicare Enrollment ID | O20240522003595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851164271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Stephanie M Garrard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427086859 PECOS PAC ID: 8820035686 Enrollment ID: I20050413000284 |
| Provider Name | Bayani Abordo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881696540 PECOS PAC ID: 9133154669 Enrollment ID: I20051003000857 |
| Provider Name | Kristen Yanchak Hirsh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720304934 PECOS PAC ID: 1759565799 Enrollment ID: I20110415000187 |
| Provider Name | Dustin R Harrison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043623929 PECOS PAC ID: 9436469509 Enrollment ID: I20191120003258 |
| Provider Name | Pilar Courtney Bendolph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588285621 PECOS PAC ID: 9537526595 Enrollment ID: I20230606002746 |
| Provider Name | Sarah Alana Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225743990 PECOS PAC ID: 1052771185 Enrollment ID: I20230720001254 |
| Provider Name | Sherry Lynn Bishop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336226703 PECOS PAC ID: 0547624751 Enrollment ID: I20230906002959 |
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