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 | 1041C0700X | Social Worker | Clinical | | | No |
| 5 | 106H00000X | Marriage & Family Therapist | | | | No |
| 6 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | | | No |
| 7 | 2084B0040X | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | | | No |
| 8 | 2084P0802X | Psychiatry & Neurology | Addiction Psychiatry | | | No |
| 9 | 251S00000X | Community/Behavioral Health | | | | No |
| 10 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | Yes |
| 11 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 12 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |