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 | 6199 | MARYLAND | Yes |
| 2 | 1041C0700X | Social Worker | Clinical | 6199 | MARYLAND | X |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | GRP # + 002 | OTHER | | TRICARE HEALTHNET |
| 2 | 2544749 | OTHER | | AUSHC HMO |
| 3 | 117781 | OTHER | | APS |
| 4 | 159551 | OTHER | | MHN |
| 5 | 292032 | OTHER | | ALLIANCE |
| 6 | 1096365 | OTHER | | FIRST HEALTH NETWORK PPO |
| 7 | 7822048 | OTHER | | AUSHC PPO |
| 8 | 220335 | OTHER | | KAISER |
| 9 | 2867 007 | OTHER | | CAREFIRST BLUE CROSS DC |
| 10 | 292032 | OTHER | | MAMSI |
| 11 | 534131 04 | OTHER | | CAREFIRST BLUE CROSS MD |
| 12 | *96 RULE | OTHER | | CCN |
| 13 | 224699 | OTHER | | COMPSYCHE MANAGED HEALTH |
| 14 | 120522 | OTHER | | JOHNS HOPKINS |
| 15 | 081N962F | MEDICARE ID-TYPE UNSPECIFIED | MARYLAND | |
| 16 | 160832 | OTHER | | VALUE OPTIONS HMS |
