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
4445 CORPORATION LN STE 264, VIRGINIA BEACH, VA 23462-3262
(252) 327-2365
Mailing address
PO BOX 31231, GREENVILLE, NC 27833-1231
(252) 327-2365
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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