Organization
OPTIMAL BEHAVIORAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMEKIA BLACKMON (MANAGER)
(252) 327-2365
Entity
Organization
Contact information
Practice address
1311 CATHERINE DR, CLEVELAND, TN 37312
(252) 327-2365
Mailing address
1311 CATHERINE DR, CLEVELAND, TN 37312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
TN
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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