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 | | | 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 | NONE | OTHER | NEW YORK | AARP UNITED HEALTH CARE |
| 2 | NONE | OTHER | WISCONSIN | TRI CARE |
| 3 | 03213816 | MEDICAID | NEW YORK | |
| 4 | 1459100 | OTHER | NEW YORK | BEACON HEALTH STRATEGIES |
| 5 | NONE | OTHER | UTAH | OPTUM BEHAVIORAL HEALTH |
| 6 | NONE | OTHER | GEORGIA | UNITED HEALTH CRAE |
| 7 | NONE | OTHER | NEW YORK | AETNA MEDICARE |
| 8 | NONE | OTHER | NEW YORK | MAGNA CARE |
| 9 | 5200775 | OTHER | NEW YORK | CIGNA BEHAVIORAL HEALTH |
| 10 | NONE | OTHER | NEW YORK | SIEBA- MAGNACARE |
| 11 | 11315 | OTHER | NEW YORK | FIDELIS |
| 12 | NONE | OTHER | NEW YORK | HEALTH FIRST |
| 13 | NONE | OTHER | NEW YORK | EMBLEM HEALTH- GHI |
| 14 | NONE | OTHER | ARKANSAS | OXFORD |
| 15 | NONE | OTHER | NEW YORK | FIDELIS |
| 16 | 741952 | OTHER | NEW YORK | VALOP |
| 17 | NONE | OTHER | NEW YORK | GLOBE LIFE INSURANCE COMPANY |
