Organization
OPTIMAL SELF LLC
Active
Other names
Lifted Anxiety - OCD Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER FARNES (OWNER)
(801) 231-5942
Entity
Organization
Contact information
Practice address
251 S MOUNTAIN RD STE 1, FRUIT HEIGHTS, UT 84037-2371
(385) 381-4950
Mailing address
251 S MOUNTAIN RD STE 1, FRUIT HEIGHTS, UT 84037-2371
(801) 643-2030
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
05/20/2024
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