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 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 2 | 251B00000X | Case Management | | | | No |
| 3 | 251E00000X | Home Health | | | | No |
| 4 | 251G00000X | Hospice Care, Community Based | | | | No |
| 5 | 251J00000X | Nursing Care | | | | No |
| 6 | 261Q00000X | Clinic/Center | | | | No |
| 7 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 8 | 323P00000X | Psychiatric Residential Treatment Facility | | | | No |
| 9 | 3336C0003X | Pharmacy | Community/Retail Pharmacy | | | No |
| 10 | 3336M0002X | Pharmacy | Mail Order Pharmacy | | | No |
| 11 | 347C00000X | Private Vehicle | | | | No |
| 12 | 372600000X | Adult Companion | | | | No |
| 13 | 385H00000X | Respite Care | | | | No |
| 14 | 385HR2055X | Respite Care | Respite Care, Mental Illness, Child | | | No |
| 15 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | Yes |