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 | 101Y00000X | Counselor | | | | No |
| 2 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 3 | 103TP2701X | Psychologist | Group Psychotherapy | | | No |
| 4 | 104100000X | Social Worker | | | | No |
| 5 | 1041C0700X | Social Worker | Clinical | | | No |
| 6 | 106H00000X | Marriage & Family Therapist | | | | No |
| 7 | 163WP0809X | Registered Nurse | Psychiatric/Mental Health, Adult | | | No |
| 8 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | | | No |
| 9 | 251B00000X | Case Management | | | | No |
| 10 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 11 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 12 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 13 | 261QR1300X | Clinic/Center | Rural Health | | | No |
| 14 | 323P00000X | Psychiatric Residential Treatment Facility | | | | No |
| 15 | 251S00000X | Community/Behavioral Health | | | | Yes |