Provider Demographics
NPI:1679286025
Name:OPTIMAL MENTAL HEALTH PLLC
Entity type:Organization
Organization Name:OPTIMAL MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LAC
Authorized Official - Phone:719-500-4460
Mailing Address - Street 1:PO BOX 16811
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80935-6811
Mailing Address - Country:US
Mailing Address - Phone:719-500-4460
Mailing Address - Fax:
Practice Address - Street 1:3440 MYERS GULCH RD STE 4
Practice Address - Street 2:
Practice Address - City:KITTREDGE
Practice Address - State:CO
Practice Address - Zip Code:80457-5049
Practice Address - Country:US
Practice Address - Phone:719-500-4460
Practice Address - Fax:719-403-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty