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 | 0904004604 | VIRGINIA | 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 | 43324 | OTHER | | BEACON HEALTH STRATEGIES |
| 2 | 44054 | OTHER | | GOVERNMENT EMPLOYEES HEALTH ASSOCIATION (GEHA) |
| 3 | 52149 | OTHER | | ONENET PPO (FORMERLY ALLIANCE PPO / MAPSI) |
| 4 | SX071 | OTHER | | CIGNA BEHAVIORAL HEALTH |
| 5 | TRP1E | OTHER | | UNIVERSAL BENEFITS - ADMIN FOR HARTFORD LIFE INSURANCE COMPANY |
| 6 | SKVA0 | MEDICAID | VIRGINIA | |
| 7 | 64157 | OTHER | | MERITAIN HEALTH |
| 8 | 81400 | OTHER | | UNITEDHEALTHCARE / ALL SAVERS ALTERNATE FUNDING |
| 9 | 87726 | OTHER | | OPTUMHEALTH BEHAVIORAL SOLUTIONS (FORMERLY UNITED BEHAVIORAL HEALTH) |
| 10 | SB690 | OTHER | | CAREFIRST BLUECROSS BLUESHIELD MD REGION |
| 11 | SX173 | OTHER | | VALUE OPTIONS - COMMERCIAL |
| 12 | 06111 | OTHER | | UNITEDHEALTHCARE / OXFORD |
| 13 | 54176 | OTHER | VIRGINIA | VIRGINIA PREMIER HEALTH PLAN |
| 14 | 60054 | OTHER | | AETNA |
| 15 | 61101 | OTHER | | HUMANA INC. |
| 16 | 75190 | OTHER | | CAREFIRST ADMINISTRATORS/NCAS |
| 17 | P55562 | MEDICARE UPIN | VIRGINIA | |
| 18 | 54176 | MEDICAID | VIRGINIA | |
| 19 | 01260 | OTHER | | MAGELLAN HEALTH SERVICES |
| 20 | 36273 | OTHER | | AARP MEDICARE SUPPLEMENT PLANS INSURED BY UNITEDHEALTHCARE INSURANCE CO |
| 21 | 87726 | OTHER | | UNITEDHEALTHCARE |
| 22 | 35115 | OTHER | | INTOTAL HEALTH |
| 23 | 54154 | OTHER | | OPTIMA HEALTH PLAN |
| 24 | 62308 | OTHER | | CIGNA |
| 25 | 04298 | OTHER | | TUFTS HEALTH PLAN |
| 26 | 57106 | OTHER | | TRICARE NORTH REGION |
| 27 | SX176 | OTHER | | TRICARE FOR LIFE |
| 28 | 0800002959 | MEDICARE NSC | VIRGINIA | |
| 29 | 39026 | OTHER | | UMR |
| 30 | 80705 | OTHER | | GREAT-WEST HEALTHCARE |
| 31 | SB923 | OTHER | | ANTHEM BLUE CROSS AND BLUE SHIELD (VIRGINIA) |
| 32 | 128VA | OTHER | | AETNA BETTER HEALTH OF VIRGINIA |
| 33 | 13551 | OTHER | | EMBLEM HEALTH (GHI - NEW YORK GROUP HEALTH INC.) |
| 34 | SMVA0 | OTHER | VIRGINIA | VA MEDICARE PART B (J11) |
