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 | 175T00000X | Peer Specialist | | | | No |
| 2 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 3 | 1041C0700X | Social Worker | Clinical | | | No |
| 4 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 5 | 2083A0300X | Preventive Medicine | Addiction Medicine | | | No |
| 6 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 7 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 8 | 363A00000X | Physician Assistant | | | | No |
| 9 | 363L00000X | Nurse Practitioner | | | | No |
| 10 | 251K00000X | Public Health or Welfare | | 700026 | MICHIGAN | Yes |
