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 | 101Y00000X | Counselor | | | | No |
| 2 | 101YM0800X | Counselor | Mental Health | | | No |
| 3 | 103G00000X | Clinical Neuropsychologist | | | | No |
| 4 | 106H00000X | Marriage & Family Therapist | | | | No |
| 5 | 163W00000X | Registered Nurse | | | | No |
| 6 | 164W00000X | Licensed Practical Nurse | | | | No |
| 7 | 164X00000X | Licensed Vocational Nurse | | | | No |
| 8 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 9 | 363AM0700X | Physician Assistant | Medical | | | No |
| 10 | 363L00000X | Nurse Practitioner | | | | No |
| 11 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 12 | 363LP2300X | Nurse Practitioner | Primary Care | | | No |
| 13 | 364SP0808X | Clinical Nurse Specialist | Psychiatric/Mental Health | | | No |
| 14 | 376K00000X | Nurse's Aide | | | | No |
| 15 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | Yes |