Organization
OPTIMAL BEHAVIORAL AND MANAGEMENT GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANETTA PITTMAN (MANAGER)
(252) 933-2199
Entity
Organization
Contact information
Practice address
2307 E HIGHWAY 76, MARION, SC 29571-6351
(843) 423-0073
Mailing address
PO BOX 955, MULLINS, SC 29574-0955
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/17/2014
Last updated
11/17/2014
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