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 | 101YM0800X | Counselor | Mental Health | | | No |
| 2 | 1041C0700X | Social Worker | Clinical | | | No |
| 3 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 4 | 251B00000X | Case Management | | | | No |
| 5 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 6 | 251V00000X | Voluntary or Charitable | | | | No |
| 7 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | Yes |
| 8 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 9 | 385H00000X | Respite Care | | | | No |
| 10 | 385HR2055X | Respite Care | Respite Care, Mental Illness, Child | | | No |
| 11 | 251S00000X | Community/Behavioral Health | | | | No |