Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
1 | 363A00000X | Physician Assistant | | | | No |
2 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
3 | 207RA0401X | Internal Medicine | Addiction Medicine | | | No |
4 | 251S00000X | Community/Behavioral Health | | | | Yes |