Provider Demographics
NPI:1629802996
Name:OPTIMUM HEALTH COUNSELING LLC
Entity type:Organization
Organization Name:OPTIMUM HEALTH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:603-580-9445
Mailing Address - Street 1:950 KAMEHAMEHA HWY UNIT 19
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-5004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:844-252-2008
Practice Address - Street 1:950 KAMEHAMEHA HWY UNIT 19
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-5004
Practice Address - Country:US
Practice Address - Phone:808-277-4413
Practice Address - Fax:844-252-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty