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 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | LAT 269 | WYOMING | No |
| 2 | 101Y00000X | Counselor | | LCPC 5870 | IDAHO | No |
| 3 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | LCPC 5870 | IDAHO | No |
| 4 | 101YM0800X | Counselor | Mental Health | LCPC 5870 | IDAHO | No |
| 5 | 101YP2500X | Counselor | Professional | LCPC 5870 | IDAHO | No |
| 6 | 101Y00000X | Counselor | | LPC732 | WYOMING | No |
| 7 | 101YM0800X | Counselor | Mental Health | LAT 269 | WYOMING | No |
| 8 | 101YM0800X | Counselor | Mental Health | LPC 732 | WYOMING | No |
| 9 | 101YP2500X | Counselor | Professional | LPC 732 | WYOMING | Yes |