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 | 171WH0202X | Contractor | Home Modifications | | | No |
| 2 | 253Z00000X | In Home Supportive Care | | | | No |
| 3 | 333300000X | Emergency Response System Companies | | | | No |
| 4 | 251S00000X | Community/Behavioral Health | | | | No |
| 5 | 251B00000X | Case Management | | 084-16-001 | VIRGINIA | No |
| 6 | 251J00000X | Nursing Care | | | | No |
| 7 | 315P00000X | Intermediate Care Facility, Intellectual Disabilities | | | | No |
| 8 | 343900000X | Non-emergency Medical Transport (VAN) | | | VIRGINIA | No |
| 9 | 225CA2400X | Rehabilitation Counselor | Assistive Technology Practitioner | | | No |
| 10 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 11 | 323P00000X | Psychiatric Residential Treatment Facility | | | | No |
| 12 | 163WC0400X | Registered Nurse | Case Management | | | No |
| 13 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | 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 | 270369 | OTHER | VIRGINIA | ANTHEM GROUP NUMBER |
| 2 | 004945310 | MEDICAID | VIRGINIA | |
| 3 | 1689615296 | MEDICAID | VIRGINIA | |
