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 | 101YP2500X | Counselor | Professional | | | No |
| 3 | 251S00000X | Community/Behavioral Health | | | | No |
| 4 | 261Q00000X | Clinic/Center | | | | No |
| 5 | 261QC1800X | Clinic/Center | Corporate Health | | | No |
| 6 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 7 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 8 | 261QR0800X | Clinic/Center | Recovery Care | | | No |
| 9 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 10 | 324500000X | Substance Abuse Rehabilitation Facility | | | | No |
| 11 | 405300000X | Prevention Professional | | | | No |
| 12 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | Yes |
