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 | 261QU0200X | Clinic/Center | Urgent Care | | | No |
| 3 | 207QA0401X | Family Medicine | Addiction Medicine | | | No |
| 4 | 208M00000X | Hospitalist | | | | No |
| 5 | 103T00000X | Psychologist | | | | No |
| 6 | 363L00000X | Nurse Practitioner | | | | No |
| 7 | 207R00000X | Internal Medicine | | | | No |
| 8 | 207Q00000X | Family Medicine | | | | No |
| 9 | 104100000X | Social Worker | | | | No |
| 10 | 207P00000X | Emergency Medicine | | | | No |
| 11 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 12 | 207QH0002X | Family Medicine | Hospice and Palliative Medicine | | | No |
| 13 | 363A00000X | Physician Assistant | | | | No |
| 14 | 106H00000X | Marriage & Family Therapist | | | | No |
| 15 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | Yes |