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 | 1041C0700X | Social Worker | Clinical | 44SC00075100 | NEW JERSEY | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 140000751NJ01 | OTHER | NEW JERSEY | ANTHEM HEALTH NETWORK |
| 2 | P451839 | OTHER | NEW JERSEY | OXFORD INSURANCE PROVIDER |
| 3 | 44SC00075100 | OTHER | NEW JERSEY | LCSW LICENSE NUMBER |
| 4 | 35141 | OTHER | NEW JERSEY | UNITED BEHAVIORAL HEALTH |
| 5 | 104200 | OTHER | NEW JERSEY | MENTAL HEALTH NETWORK |
| 6 | OK5408 | OTHER | NEW JERSEY | PHYSICANS HEALTH SERVICES |
| 7 | 640680 | MEDICARE ID-TYPE UNSPECIFIED | NEW JERSEY | PROVIDER NUMBER |
| 8 | N1B061 | OTHER | NEW JERSEY | EMPIRE B/C B/S PROVIDER # |
| 9 | J024934 | OTHER | NEW JERSEY | CHAMPUS PROVIDER NUMBER |
| 10 | 039398 | OTHER | NEW JERSEY | VALUE OPTIONS PROVIDER # |
