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 | 103G00000X | Clinical Neuropsychologist | | PY7652 | FLORIDA | No |
| 2 | 103G00000X | Clinical Neuropsychologist | | 3189 | NORTH CAROLINA | Yes |
| 3 | 103TB0200X | Psychologist | Cognitive & Behavioral | PY7652 | FLORIDA | No |
| 4 | 103TC0700X | Psychologist | Clinical | PY7652 | FLORIDA | No |
| 5 | 103TC0700X | Psychologist | Clinical | 3189 | NORTH CAROLINA | No |
| 6 | 103TH0100X | Psychologist | Health Service | 3189 | NORTH CAROLINA | No |
| 7 | 103TR0400X | Psychologist | Rehabilitation | PY7652 | FLORIDA | No |
| 8 | 103TR0400X | Psychologist | Rehabilitation | 3189 | NORTH CAROLINA | No |
| 9 | 103TH0004X | Psychologist | Health | PY7652 | FLORIDA | No |
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 | 046VX | OTHER | NORTH CAROLINA | BLUE CROSS BLUE SHIELD |
| 2 | 6001025 | MEDICAID | NORTH CAROLINA | |
| 3 | HH800B | OTHER | FLORIDA | MEDICARE |
| 4 | 51518 | OTHER | NORTH CAROLINA | NATIONAL REGISTER |
| 5 | 1700860137 | OTHER | FLORIDA | NATIONAL PROVIDER IDENTIFIER (NPI) |
| 6 | P00462649 | OTHER | NORTH CAROLINA | MEDICARE RAILROAD CARRIER |
| 7 | 56162 | OTHER | NORTH CAROLINA | MEDCOST PREFERRED PROVIDER |
| 8 | PIN: 399895 | OTHER | NORTH CAROLINA | MHN A HEALTH NET COMPANY |
| 9 | FH5000445 | OTHER | NORTH CAROLINA | FIRST CAROLINA CARE INSURANCE COMPANY |
| 10 | HP581Y | OTHER | FLORIDA | MEDICARE |
| 11 | 106487600 | MEDICAID | FLORIDA | |
| 12 | 106536400 | MEDICAID | FLORIDA | |
| 13 | 1609219013 | OTHER | FLORIDA | NATIONAL PROVIDER IDENTIFIER (NPI) DR. DELIGHT PA |
| 14 | 593UE | OTHER | FLORIDA | BLUE CROSS BLUE SHIELD |
| 15 | QKS1F | OTHER | FLORIDA | BCBS-FL GROUP |
