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 | 104100000X | Social Worker | | | | No |
| 3 | 1041C0700X | Social Worker | Clinical | | | No |
| 4 | 225C00000X | Rehabilitation Counselor | | | | No |
| 5 | 251S00000X | Community/Behavioral Health | | | | No |
| 6 | 261QF0400X | Clinic/Center | Federally Qualified Health Center (FQHC) | | | No |
| 7 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 8 | 324500000X | Substance Abuse Rehabilitation Facility | | | | Yes |
| 9 | 3245S0500X | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | | | No |