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 | 1041C0700X | Social Worker | Clinical | 032697-1 | NEW YORK | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 1018520 | OTHER | NEW YORK | BEACONHLTHSTRAT PROV ID |
| 2 | 145110 | OTHER | NEW YORK | EMPIRE PLAN VALUE OPTIONS |
| 3 | 7484685 | OTHER | NEW YORK | VALUEOPTIONS PIN |
| 4 | 7484685 | OTHER | NEW YORK | GHI-BMP PIN |
| 5 | 145110 | OTHER | NEW YORK | VALUEOPTIONS MHS-TIN |
| 6 | 01478371 | MEDICAID | NEW YORK | |
| 7 | 145110 | OTHER | NEW YORK | NYSHIP |
| 8 | AM959074 | OTHER | NEW YORK | GHP-BMP PIN |
| 9 | R48339 | MEDICARE UPIN | NEW YORK | |
| 10 | 1018520 | OTHER | NEW YORK | AFFINITY PROV ID |
| 11 | 373120 | OTHER | NEW YORK | MVP HEALTHCARE PROV ID |
| 12 | WS1357 | OTHER | NEW YORK | OXFORD PROV ID |
| 13 | 1018520 | OTHER | NEW YORK | HEALTHSOURCE PROV ID |
| 14 | N5I501 | MEDICARE PIN | NEW YORK | |
