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 | 103TH0100X | Psychologist | Health Service | | | No |
| 2 | 251S00000X | Community/Behavioral Health | | | | No |
| 3 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 4 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 5 | 261QR0800X | Clinic/Center | Recovery Care | | | No |
| 6 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 7 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 8 | 101YM0800X | Counselor | Mental Health | | | No |
| 9 | 103T00000X | Psychologist | | | | No |
| 10 | 103TA0700X | Psychologist | Adult Development & Aging | | | No |
| 11 | 103TB0200X | Psychologist | Cognitive & Behavioral | | | No |
| 12 | 103TC1900X | Psychologist | Counseling | | | No |
| 13 | 103TC2200X | Psychologist | Clinical Child & Adolescent | | | No |
| 14 | 103TF0000X | Psychologist | Family | | | No |
| 15 | 101Y00000X | Counselor | | | | Yes |
