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 | 103TA0700X | Psychologist | Adult Development & Aging | PSY 002463 | GEORGIA | No |
| 2 | 103TB0200X | Psychologist | Cognitive & Behavioral | PSY 002463 | GEORGIA | No |
| 3 | 103TC0700X | Psychologist | Clinical | PSY 002463 | GEORGIA | No |
| 4 | 103TC1900X | Psychologist | Counseling | PSY 002463 | GEORGIA | No |
| 5 | 103TH0004X | Psychologist | Health | 1405 | SOUTH CAROLINA | No |
| 6 | 103TP0814X | Psychologist | Psychoanalysis | PSY 002463 | GEORGIA | No |
| 7 | 103TP2701X | Psychologist | Group Psychotherapy | PSY 002463 | GEORGIA | No |
| 8 | 103TC0700X | Psychologist | Clinical | 1405 | SOUTH CAROLINA | Yes |