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 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 2 | 103T00000X | Psychologist | | | | No |
| 3 | 103TP2701X | Psychologist | Group Psychotherapy | | | No |
| 4 | 104100000X | Social Worker | | | | No |
| 5 | 163W00000X | Registered Nurse | | | | No |
| 6 | 171100000X | Acupuncturist | | | | No |
| 7 | 172M00000X | Mechanotherapist | | | | No |
| 8 | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | | | | No |
| 9 | 207R00000X | Internal Medicine | | | | No |
| 10 | 221700000X | Art Therapist | | | | No |
| 11 | 2255A2300X | Specialist/Technologist | Athletic Trainer | | | No |
| 12 | 225700000X | Massage Therapist | | | | No |
| 13 | 225A00000X | Music Therapist | | | | No |
| 14 | 374K00000X | Religious Nonmedical Practitioner | | | | No |
| 15 | 363LA2200X | Nurse Practitioner | Adult Health | | | Yes |