Provider Demographics
NPI:1285358598
Name:OPTIMUM MENTAL HEALTHCARE PROFESSIONALS, PLLC
Entity type:Organization
Organization Name:OPTIMUM MENTAL HEALTHCARE PROFESSIONALS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIRBER
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:605-431-5806
Mailing Address - Street 1:323 E ENCHANTED PINES DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-9263
Mailing Address - Country:US
Mailing Address - Phone:605-431-5806
Mailing Address - Fax:
Practice Address - Street 1:804 WEST BLVD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-3577
Practice Address - Country:US
Practice Address - Phone:605-431-5806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty