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 | 1041C0700X | Social Worker | Clinical | | | No |
| 3 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | | | No |
| 4 | 251B00000X | Case Management | | | | No |
| 5 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 6 | 261QM2500X | Clinic/Center | Medical Specialty | | | No |
| 7 | 261QR0401X | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | | | No |
| 8 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 9 | 324500000X | Substance Abuse Rehabilitation Facility | | | | No |
| 10 | 251S00000X | Community/Behavioral Health | | | | Yes |