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 | 2084P0804X | Psychiatry & Neurology | Child & Adolescent Psychiatry | | | No |
| 2 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 3 | 102L00000X | Psychoanalyst | | | | No |
| 4 | 163WP0807X | Registered Nurse | Psychiatric/Mental Health, Child & Adolescent | | | No |
| 5 | 2084B0040X | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | | | No |
| 6 | 101YM0800X | Counselor | Mental Health | | | No |
| 7 | 103TF0000X | Psychologist | Family | | | No |
| 8 | 103TP0016X | Psychologist | Prescribing (Medical) | | | No |
| 9 | 167G00000X | Licensed Psychiatric Technician | | | | No |
| 10 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 11 | 2084P0301X | Psychiatry & Neurology | Brain Injury Medicine | | | No |
| 12 | 207R00000X | Internal Medicine | | | | No |
| 13 | 103TB0200X | Psychologist | Cognitive & Behavioral | | | No |
| 14 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 15 | 207Q00000X | Family Medicine | | | | Yes |