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 | 2084B0040X | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | 07048002 | MICHIGAN | Yes |
| 2 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 3 | 101YM0800X | Counselor | Mental Health | | | No |
| 4 | 101YP2500X | Counselor | Professional | | | No |
| 5 | 103T00000X | Psychologist | | | | No |
| 6 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | | | No |
| 7 | 103TP0016X | Psychologist | Prescribing (Medical) | | | No |
| 8 | 171000000X | Military Health Care Provider | | | | No |
| 9 | 1710I1002X | Military Health Care Provider | Independent Duty Corpsman | | | No |
| 10 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | 07048002 | MICHIGAN | No |
| 11 | 2085R0001X | Radiology | Radiation Oncology | 07048002 | MICHIGAN | No |
| 12 | 390200000X | Student in an Organized Health Care Education/Training Program | | | | No |
