Provider Demographics
NPI:1598573248
Name:OPTIMAL PSYCHOLOGICAL AND CONSULTING SERVICES
Entity type:Organization
Organization Name:OPTIMAL PSYCHOLOGICAL AND CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:704-550-6898
Mailing Address - Street 1:4227 W 108TH PL
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-5351
Mailing Address - Country:US
Mailing Address - Phone:704-550-6898
Mailing Address - Fax:888-500-1740
Practice Address - Street 1:7250 W COLLEGE DR STE 202C
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1151
Practice Address - Country:US
Practice Address - Phone:704-550-6898
Practice Address - Fax:888-500-1740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty