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 | 2084P0804X | Psychiatry & Neurology | Child & Adolescent Psychiatry | | | No |
| 2 | 251B00000X | Case Management | | | | No |
| 3 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 4 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 5 | 261QM1300X | Clinic/Center | Multi-Specialty | | | No |
| 6 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 7 | 343900000X | Non-emergency Medical Transport (VAN) | | | | No |
| 8 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 9 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 10 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 11 | 101YP2500X | Counselor | Professional | | | No |
| 12 | 103TC1900X | Psychologist | Counseling | | | No |
| 13 | 104100000X | Social Worker | | | | No |
| 14 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 15 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | Yes |
