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 | ISW01446 | RHODE ISLAND | No |
| 2 | 1041C0700X | Social Worker | Clinical | SW6688 | FLORIDA | 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 | 050258858 | OTHER | RHODE ISLAND | PACIFICARE-GROUP |
| 2 | 0901589 | MEDICARE UPIN | RHODE ISLAND | |
| 3 | 31157-3 | OTHER | RHODE ISLAND | BLUE SHIELD |
| 4 | 1021740 | OTHER | RHODE ISLAND | NHP/BEACON GROUP |
| 5 | 12397075 | OTHER | RHODE ISLAND | MULTIPLAN |
| 6 | U2092A | MEDICARE PIN | FLORIDA | |
| 7 | 8274442000 | OTHER | RHODE ISLAND | MAGELLAN |
| 8 | 007058364 | MEDICARE UPIN | RHODE ISLAND | |
| 9 | EC59037 | MEDICAID | RHODE ISLAND | |
| 10 | 000316 | MEDICARE OSCAR/CERTIFICATION | RHODE ISLAND | |
| 11 | 62-35076 | OTHER | RHODE ISLAND | UNITED BEHAVIORAL HEALTH |
| 12 | 526273 | OTHER | RHODE ISLAND | VALUE OPTIONS |
| 13 | 413245 | OTHER | RHODE ISLAND | BLUE CHIP |
