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 | 101YP2500X | Counselor | Professional | LPC8031-125 | WISCONSIN | No |
| 2 | 101YP2500X | Counselor | Professional | LPC16308 | COLORADO | No |
| 3 | 101YP2500X | Counselor | Professional | LCPC02928 | KANSAS | No |
| 4 | 101YP2500X | Counselor | Professional | LMHC39003814A | INDIANA | No |
| 5 | 101YP2500X | Counselor | Professional | LPCC4199 | CALIFORNIA | Yes |
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 | LPCC4199 | OTHER | CALIFORNIA | STATE OF CALIFORNIA BOARD OF BEHAVIORAL SCIENCES |
| 2 | LPC16308 | OTHER | COLORADO | STATE OF COLORADO BOARD OF LICENSED PROFESSIONAL COUNSELOR EXAMINERS |
| 3 | NCC1023336 | OTHER | | NATIONAL BOARD FOR CERTIFIED COUNSELORS |
| 4 | LCPC02928 | OTHER | KANSAS | STATE OF KANSAS BEHAVIORAL SCIENCES REGULATORY BOARD |
| 5 | LPC8031-125 | OTHER | WISCONSIN | STATE OF WISCONSIN PROFESSIONAL LICENSING AGENCY |
| 6 | BC-TMH-2991 | OTHER | | CENTER FOR CREDENTIALING & EDUCATION |
| 7 | LMHC39003814A | OTHER | INDIANA | STATE OF INDIANA PROFESSIONAL LICENSING AGENCY |
| 8 | LPC-MH30686 | OTHER | SOUTH DAKOTA | SOUTH DAKOTA BOARD OF EXAMINERS FOR COUNSELORS & MARRIAGE & FAMILY THERAPISTS |
| 9 | CCMHC-1023336 | OTHER | | NATIONAL BOARD FOR CERTIFIED COUNSELORS |
