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 | 103TM1800X | Psychologist | Intellectual and Developmental Disabilities | | | No |
| 2 | 251B00000X | Case Management | | | | No |
| 3 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 4 | 343800000X | Secured Medical Transport (VAN) | | | | No |
| 5 | 343900000X | Non-emergency Medical Transport (VAN) | | | | No |
| 6 | 373H00000X | Day Training/Habilitation Specialist | | | | No |
| 7 | 251S00000X | Community/Behavioral Health | | | | Yes |