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 | 251S00000X | Community/Behavioral Health | | 173-040 | NEW JERSEY | No |
2 | 261QM0850X | Clinic/Center | Adult Mental Health | 173-040 | NEW JERSEY | No |
3 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | 173-040 | NEW JERSEY | No |
4 | 261QM1102X | Clinic/Center | Military Outpatient Operational (Transportable) Component | 173-040 | NEW JERSEY | No |
5 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | 173-040 | NEW JERSEY | No |
6 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | 173-040 | NEW JERSEY | Yes |