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 | 261QM1300X | Clinic/Center | Multi-Specialty | MHL 051-128 | NORTH CAROLINA | No |
| 2 | 2084P0802X | Psychiatry & Neurology | Addiction Psychiatry | MHL 051-128 | NORTH CAROLINA | No |
| 3 | 251B00000X | Case Management | | MHL 051-128 | NORTH CAROLINA | No |
| 4 | 251K00000X | Public Health or Welfare | | MHL 051-128 | NORTH CAROLINA | No |
| 5 | 251S00000X | Community/Behavioral Health | | MHL 051-128 | NORTH CAROLINA | No |
| 6 | 251E00000X | Home Health | | MHL 051-128 | NORTH CAROLINA | No |
| 7 | 101YM0800X | Counselor | Mental Health | MHL 051-128 | NORTH CAROLINA | No |
| 8 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | MHL 051-128 | NORTH CAROLINA | 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 | MHL 051-128 | OTHER | NORTH CAROLINA | MENTAL HEALTH LICENSE |
