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 | 101Y00000X | Counselor | | | | No |
| 2 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 3 | 101YM0800X | Counselor | Mental Health | | | No |
| 4 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | | | No |
| 5 | 103TC1900X | Psychologist | Counseling | | | No |
| 6 | 103TC2200X | Psychologist | Clinical Child & Adolescent | | | No |
| 7 | 104100000X | Social Worker | | | | No |
| 8 | 1041C0700X | Social Worker | Clinical | | | Yes |
| 9 | 106H00000X | Marriage & Family Therapist | | | | No |
| 10 | 171400000X | Health and Wellness Coach | | | | No |
| 11 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 12 | 172V00000X | Community Health Worker | | | | No |
| 13 | 175T00000X | Peer Specialist | | | | No |
| 14 | 251X00000X | Supports Brokerage | | | | No |
| 15 | 405300000X | Prevention Professional | | | | No |