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 | 101Y00000X | Counselor | | | | No |
| 2 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 3 | 101YP1600X | Counselor | Pastoral | | | No |
| 4 | 102L00000X | Psychoanalyst | | | | No |
| 5 | 103G00000X | Clinical Neuropsychologist | | | | No |
| 6 | 103K00000X | Behavior Analyst | | | | No |
| 7 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | | | No |
| 8 | 103TA0700X | Psychologist | Adult Development & Aging | | | No |
| 9 | 103TF0000X | Psychologist | Family | | | No |
| 10 | 103TF0200X | Psychologist | Forensic | | | No |
| 11 | 104100000X | Social Worker | | | | No |
| 12 | 163W00000X | Registered Nurse | | | | No |
| 13 | 163WC0400X | Registered Nurse | Case Management | | | No |
| 14 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 15 | 1041C0700X | Social Worker | Clinical | | | Yes |