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 | 103K00000X | Behavior Analyst | | | | No |
| 3 | 103TC2200X | Psychologist | Clinical Child & Adolescent | | | No |
| 4 | 171400000X | Health and Wellness Coach | | | | No |
| 5 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 6 | 251B00000X | Case Management | | | | No |
| 7 | 251S00000X | Community/Behavioral Health | | | | No |
| 8 | 253J00000X | Foster Care Agency | | | | No |
| 9 | 310500000X | Intermediate Care Facility, Mental Illness | | | | No |
| 10 | 363LA2100X | Nurse Practitioner | Acute Care | | | No |
| 11 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 12 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | Yes |