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 | 103G00000X | Clinical Neuropsychologist | | | | No |
5 | 103T00000X | Psychologist | | | | No |
6 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | | | No |
7 | 103TC0700X | Psychologist | Clinical | | | No |
8 | 103TC1900X | Psychologist | Counseling | | | No |
9 | 103TF0000X | Psychologist | Family | | | No |
10 | 103TF0200X | Psychologist | Forensic | | | No |
11 | 103TP2701X | Psychologist | Group Psychotherapy | | | No |
12 | 163WI0500X | Registered Nurse | Infusion Therapy | | | No |
13 | 175T00000X | Peer Specialist | | | | No |
14 | 251B00000X | Case Management | | | | No |
15 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | | | Yes |