Provider Demographics
NPI:1558171140
Name:OPTIMIZE PSYCHOLOGICAL HEALTH PLLC
Entity type:Organization
Organization Name:OPTIMIZE PSYCHOLOGICAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:312-952-7792
Mailing Address - Street 1:10 MONROE BLVD APT 6S
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4359
Mailing Address - Country:US
Mailing Address - Phone:312-952-7792
Mailing Address - Fax:
Practice Address - Street 1:10 MONROE BLVD APT 6S
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4359
Practice Address - Country:US
Practice Address - Phone:312-952-7792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty