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 | 104100000X | Social Worker | | | | No |
| 3 | 106S00000X | Behavior Technician | | | | No |
| 4 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 5 | 175T00000X | Peer Specialist | | | | No |
| 6 | 225C00000X | Rehabilitation Counselor | | | | No |
| 7 | 225CX0006X | Rehabilitation Counselor | Orientation and Mobility Training Provider | | | No |
| 8 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 9 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
| 10 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 11 | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | | | | No |
| 12 | 385HR2050X | Respite Care | Respite Care Camp | | | No |
| 13 | 385HR2060X | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities | | | No |
| 14 | 103TP2701X | Psychologist | Group Psychotherapy | | | Yes |