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 | 101YM0800X | Counselor | Mental Health | | | No |
| 2 | 163W00000X | Registered Nurse | | | | No |
| 3 | 164X00000X | Licensed Vocational Nurse | | | | No |
| 4 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 5 | 172V00000X | Community Health Worker | | | | No |
| 6 | 2083P0901X | Preventive Medicine | Public Health & General Preventive Medicine | | | No |
| 7 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 8 | 363LC1500X | Nurse Practitioner | Community Health | | | No |
| 9 | 207R00000X | Internal Medicine | | | | Yes |