Organization
OPTIMISTIC WELLNESS LLC
Active
Organization
OPTIMISTIC WELLNESS LLC
Active
Other names
Consumer Protection Law, Dequan' Dr. Dequan'
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELDON B HAYNES M.D. (CONSULTANT)
(785) 817-1893
Entity
Organization
Contact information
Practice address
5119 NW KENDALL CT, TOPEKA, KS 66618-1269
(785) 817-1893
(785) 587-0009
Mailing address
5119 NW KENDALL CT, TOPEKA, KS 66618-1269
(785) 817-1893
(785) 578-0009
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
247000000X
Health Information Technician
—
—
251B00000X
Case Management Agency
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5617545
DEA
KS
05
—
BH5617545
—
KS
01
—
KS-ASCX12N
OLD LICENCE
KS
05
—
KS04-64104
—
KS
Enumeration date
11/06/2023
Last updated
12/12/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up