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 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 2 | 103K00000X | Behavior Analyst | | | | No |
| 3 | 103TB0200X | Psychologist | Cognitive & Behavioral | | | No |
| 4 | 103TH0100X | Psychologist | Health Service | | | No |
| 5 | 163WP0807X | Registered Nurse | Psychiatric/Mental Health, Child & Adolescent | | | No |
| 6 | 163WP0808X | Registered Nurse | Psychiatric/Mental Health | | | No |
| 7 | 172V00000X | Community Health Worker | | | | No |
| 8 | 251B00000X | Case Management | | | | No |
| 9 | 251E00000X | Home Health | | | | No |
| 10 | 251S00000X | Community/Behavioral Health | | | | Yes |
| 11 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |