Organization
OPTUM BEHAVIORAL CARE OF COLORADO, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE JOHNSON (CEO)
(704) 506-6267
Entity
Organization
Contact information
Practice address
670 HAWTHORNE AVE SE STE 40, SALEM, OR 97301-6884
(503) 316-6770
Mailing address
67 BURNSIDE AVE, EAST HARTFORD, CT 06108-3408
(704) 506-6267
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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