Optum Behavioral Care of Colorado, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

OPTUM BEHAVIORAL CARE OF COLORADO, P.C.

Practice address

12970 W Bluemound Rd Ste 200
Elm Grove, WI 53122-2607

Phone

(704) 506-6267

NPI assigned

Jan 5, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leslie Johnson

Title

Ceo

Phone

(704) 506-6267

Specialties & licenses 1

Addresses

Other names 1

• Red Oak Counseling of Wisconsin Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Optum Behavioral Care of Colorado, P.C.

  • Counseling Psychologist
  • Fond Du Lac, WI
  • NPI 1104688365

  O20240429000918

  Same enrollment
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494

  O20240429000918

  Same enrollment
• Optum Behavioral Care of Colorado, P.C.

  • Counseling Psychologist
  • Appleton, WI
  • NPI 1487424826

  O20240429000918

  Same enrollment
• Optum Behavioral Care of Colorado, P.C.

  • Counseling Psychologist
  • Green Bay, WI
  • NPI 1538921796

  O20240429000918

  Same enrollment
• Optum Behavioral Care of Colorado, P.C.

  • Counseling Psychologist
  • Stevens Point, WI
  • NPI 1639931892

  O20240429000918

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cindy J Keller, MSW

  • Clinical Social Worker
  • Fergus Falls, MN
  • NPI 1184642746
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1750151189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 OPTUM CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442503",
            "telephone_number": "704-506-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12970 W BLUEMOUND RD STE 200",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222607",
            "telephone_number": "704-506-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM BEHAVIORAL CARE OF COLORADO, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-506-6267"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Oak Counseling of Wisconsin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• New Leaf Psychotherapy LLC
• Minh Ngoc Ngo, MSE
• Katherine Mary O'Keeffe, SLP
• Andrea Oconnell, RN
• Gina Marie Oliveri
• Anne Catherine Paczesny, LCSW
• Pals Inc
• David Andrew Paris, D.D.S.
• Patchwork Counseling Collective LLC
• Joseph Anthony Pavletich Jr., D.D.S.

• Clinical Psychologist in Elm Grove, WI
• Providers in Elm Grove, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.