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 | 101YM0800X | Counselor | Mental Health | 508 | MARYLAND | Yes |
| 2 | 103TC1900X | Psychologist | Counseling | 508 | MARYLAND | No |
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 | 7503017 PPO | OTHER | | AUSHC AETNA |
| 2 | 26765 | OTHER | | JOHN HOPKINS USFHP EHP |
| 3 | 341100 01 | OTHER | | CAREFIRST BLUE CROSS MD |
| 4 | 28670003 | OTHER | | CAREFIRST BLUE CROSS DC |
| 5 | 31493 | OTHER | | ALLIANCE |
| 6 | 45981 | OTHER | | CIGNA PPO |
| 7 | PAR | OTHER | | CHOICE CARE |
| 8 | 097362 | OTHER | | HMC |
| 9 | 967098 | OTHER | | FIRST HEALTH NETWORK PPO |
| 10 | 1992 | OTHER | | APS (INCLUDES MOTOROLA) |
| 11 | KAIRER | OTHER | | 207991 |
| 12 | 165351 | OTHER | | COMPSYCHE MANAGED HEALTH |
| 13 | 45981PAR | OTHER | | CIGNA BEHAVIORAL HEALTH |
