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 | No |
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 | 120522 | OTHER | | JOHNS HOPKINS |
| 2 | 159551 | OTHER | | MHN |
| 3 | 160832 | OTHER | | VALUE OPTIONS HMS |
| 4 | 2544749 | OTHER | | AUSHC HMO |
| 5 | 534131 04 | OTHER | | CAREFIRST BLUE CROSS MD |
| 6 | *96 RULE | OTHER | | CCN |
| 7 | 117781 | OTHER | | APS |
| 8 | 220335 | OTHER | | KAISER |
| 9 | 224699 | OTHER | | COMPSYCHE MANAGED HEALTH |
| 10 | 292032 | OTHER | | ALLIANCE |
| 11 | 292032 | OTHER | | MAMSI |
| 12 | 1096365 | OTHER | | FIRST HEALTH NETWORK PPO |
| 13 | 2867 007 | OTHER | | CAREFIRST BLUE CROSS DC |
| 14 | 7822048 | OTHER | | AUSHC PPO |
| 15 | GRP # + 002 | OTHER | | TRICARE HEALTHNET |
