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 | 101YP1600X | Counselor | Pastoral | | | No |
| 3 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | | | No |
| 4 | 1041C0700X | Social Worker | Clinical | | | No |
| 5 | 133NN1002X | Nutritionist | Nutrition, Education | | | No |
| 6 | 163W00000X | Registered Nurse | | | | No |
| 7 | 164W00000X | Licensed Practical Nurse | | | | No |
| 8 | 202C00000X | Independent Medical Examiner | | | | No |
| 9 | 207Q00000X | Family Medicine | | | | No |
| 10 | 207R00000X | Internal Medicine | | | | No |
| 11 | 2083P0500X | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine | | | No |
| 12 | 2084P0802X | Psychiatry & Neurology | Addiction Psychiatry | | | No |
| 13 | 208VP0000X | Pain Medicine | Pain Medicine | | | No |
| 14 | 363A00000X | Physician Assistant | | | | No |
| 15 | 2083A0300X | Preventive Medicine | Addiction Medicine | | | Yes |