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 | 2084P0800X | Psychiatry & Neurology | Psychiatry | SC#30663 | SOUTH CAROLINA | No |
| 2 | 2084P0800X | Psychiatry & Neurology | Psychiatry | 30663 | SOUTH CAROLINA | No |
| 3 | 2084P0802X | Psychiatry & Neurology | Addiction Psychiatry | SC#30663 | SOUTH CAROLINA | No |
| 4 | 2084P0802X | Psychiatry & Neurology | Addiction Psychiatry | 30663 | SOUTH CAROLINA | No |
| 5 | 2084P0805X | Psychiatry & Neurology | Geriatric Psychiatry | SC#30663 | SOUTH CAROLINA | No |
| 6 | 2084P0015X | Psychiatry & Neurology | Psychosomatic Medicine | 30663 | SOUTH CAROLINA | Yes |