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Organization

OPTUM BEHAVIORAL CARE OF COLORADO, P.C.

Active
Other names
Awakened Heart Portland
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE FUCHS (CEO)
(810) 358-1643
Entity
Organization

Contact information

Practice address
1306 NW HOYT ST STE 407, PORTLAND, OR 97209-2787
(971) 407-3930
(888) 515-7502
Mailing address
3115 NE SANDY BLVD STE 225, PORTLAND, OR 97232-2777
(971) 407-3930
(888) 515-7502

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist

Other

Enumeration date
08/29/2024
Last updated
09/05/2024
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