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 | 261QM0850X | Clinic/Center | Adult Mental Health | | RHODE ISLAND | No |
| 2 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | RHODE ISLAND | No |
| 3 | 324500000X | Substance Abuse Rehabilitation Facility | | | RHODE ISLAND | No |
| 4 | 3245S0500X | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | | RHODE ISLAND | No |
| 5 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | RHODE ISLAND | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 253474 | OTHER | RHODE ISLAND | MAGELLAN BEHAVIORAL HLTH |
| 2 | 334543 | OTHER | RHODE ISLAND | VALUE OPTIONS |
| 3 | 334543 | OTHER | RHODE ISLAND | EMPIRE NETWORK |
| 4 | 30774-5 | OTHER | RHODE ISLAND | BCBSRI (HCFA) |
| 5 | 410887 | OTHER | RHODE ISLAND | BCBSRI BLUE CHIP (HCFA) |
| 6 | 1022660 | OTHER | RHODE ISLAND | BEACON HEALTH STRATEGIES |
| 7 | A2833203 | OTHER | RHODE ISLAND | OXFORF HEALTH PLANS |
| 8 | CH-04437 | MEDICAID | RHODE ISLAND | |
| 9 | 7891442 | OTHER | RHODE ISLAND | AETNA |
| 10 | 409686 | OTHER | RHODE ISLAND | BCBSRI BLUE CHIP (UB) |
| 11 | 5079653 | OTHER | RHODE ISLAND | UNITED HEALTH |
| 12 | 6997-7 | OTHER | RHODE ISLAND | BCBS RI (UB) |
