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 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
3 | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | | | | No |
4 | 251B00000X | Case Management | | | | Yes |