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 | 171400000X | Health and Wellness Coach | | | | No |
| 3 | 175F00000X | Naturopath | | | | No |
| 4 | 2081P0301X | Physical Medicine & Rehabilitation | Brain Injury Medicine | | | No |
| 5 | 2083C0008X | Preventive Medicine | Clinical Informatics | | | No |
| 6 | 2084P0804X | Psychiatry & Neurology | Child & Adolescent Psychiatry | | | No |
| 7 | 2084S0010X | Psychiatry & Neurology | Sports Medicine | | | No |
| 8 | 2084S0012X | Psychiatry & Neurology | Sleep Medicine | | | No |
| 9 | 208D00000X | General Practice | | | | No |
| 10 | 246QL0900X | Specialist/Technologist, Pathology | Laboratory Management | | | No |
| 11 | 246ZE0500X | Specialist/Technologist, Other | EEG | | | No |
| 12 | 246ZE0600X | Specialist/Technologist, Other | Electroneurodiagnostic | | | No |
| 13 | 261QR1100X | Clinic/Center | Research | | | No |
| 14 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 15 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | Yes |