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 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 2 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 3 | 261QM2500X | Clinic/Center | Medical Specialty | | | No |
| 4 | 385H00000X | Respite Care | | | | No |
| 5 | 385HR2055X | Respite Care | Respite Care, Mental Illness, Child | | | No |
| 6 | 251S00000X | Community/Behavioral Health | | | | No |
| 7 | 253J00000X | Foster Care Agency | | | | No |
| 8 | 253Z00000X | In Home Supportive Care | | | | No |
| 9 | 261QC1500X | Clinic/Center | Community Health | | | No |
| 10 | 261QH0100X | Clinic/Center | Health Service | | | No |
| 11 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 12 | 251K00000X | Public Health or Welfare | | | | No |
| 13 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 14 | 104100000X | Social Worker | | | | No |
| 15 | 251B00000X | Case Management | | | | Yes |