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 | 251B00000X | Case Management | | | | No |
| 2 | 261QM1300X | Clinic/Center | Multi-Specialty | | | No |
| 3 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | 627 | RHODE ISLAND | No |
| 4 | 276400000X | Rehabilitation, Substance Use Disorder Unit | | | RHODE ISLAND | No |
| 5 | 172V00000X | Community Health Worker | | | | No |
| 6 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | RHODE ISLAND | No |
| 7 | 324500000X | Substance Abuse Rehabilitation Facility | | | | No |
| 8 | 310400000X | Assisted Living Facility | | | RHODE ISLAND | No |
| 9 | 251K00000X | Public Health or Welfare | | | | No |
| 10 | 251300000X | Local Education Agency (LEA) | | | | No |
| 11 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 12 | 225400000X | Rehabilitation Practitioner | | | | No |
| 13 | 175T00000X | Peer Specialist | | | | No |
| 14 | 405300000X | Prevention Professional | | | | No |
| 15 | 251S00000X | Community/Behavioral Health | | | 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 | NR02178 | MEDICAID | RHODE ISLAND | |
| 2 | NR02172 | MEDICAID | RHODE ISLAND | |
| 3 | NR14021 | MEDICAID | RHODE ISLAND | |
| 4 | 69250 | OTHER | RHODE ISLAND | BLUE CROSS SA |
| 5 | CP00408220 | OTHER | RHODE ISLAND | BCHIP SA |
| 6 | CR32696 | MEDICAID | RHODE ISLAND | |
| 7 | 259109 | OTHER | RHODE ISLAND | BC MA |
| 8 | 1021720 | OTHER | RHODE ISLAND | UBH |
