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 | 101YM0800X | Counselor | Mental Health | | | No |
| 3 | 103TP2701X | Psychologist | Group Psychotherapy | | | No |
| 4 | 1041C0700X | Social Worker | Clinical | | | No |
| 5 | 106H00000X | Marriage & Family Therapist | | | | No |
| 6 | 133N00000X | Nutritionist | | | | No |
| 7 | 133V00000X | Dietitian, Registered | | | | No |
| 8 | 163W00000X | Registered Nurse | | | | No |
| 9 | 163WC0400X | Registered Nurse | Case Management | | | No |
| 10 | 163WP0808X | Registered Nurse | Psychiatric/Mental Health | | | No |
| 11 | 164W00000X | Licensed Practical Nurse | | | | No |
| 12 | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | | | | No |
| 13 | 374U00000X | Home Health Aide | | | | No |
| 14 | 385HR2055X | Respite Care | Respite Care, Mental Illness, Child | | | No |
| 15 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | Yes |
