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 | 103G00000X | Clinical Neuropsychologist | | 012695 | NEW YORK | No |
| 2 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | 012695 | NEW YORK | No |
| 3 | 103TA0700X | Psychologist | Adult Development & Aging | 012695 | NEW YORK | No |
| 4 | 103TC0700X | Psychologist | Clinical | 012695 | NEW YORK | No |
| 5 | 103TC2200X | Psychologist | Clinical Child & Adolescent | 012695 | NEW YORK | No |
| 6 | 103TF0200X | Psychologist | Forensic | 012695 | NEW YORK | No |
| 7 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | 3635 | NORTH CAROLINA | No |
| 8 | 103TA0700X | Psychologist | Adult Development & Aging | 3635 | NORTH CAROLINA | No |
| 9 | 103TC0700X | Psychologist | Clinical | 3635 | NORTH CAROLINA | No |
| 10 | 103TF0200X | Psychologist | Forensic | 3635 | NORTH CAROLINA | No |
| 11 | 106H00000X | Marriage & Family Therapist | | 3635 | NORTH CAROLINA | No |
| 12 | 103TP0814X | Psychologist | Psychoanalysis | 3635 | NORTH CAROLINA | No |
| 13 | 103G00000X | Clinical Neuropsychologist | | 3635 | NORTH CAROLINA | Yes |
