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 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 2 | 101YM0800X | Counselor | Mental Health | | | No |
| 3 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | | | No |
| 4 | 103TP0016X | Psychologist | Prescribing (Medical) | | | No |
| 5 | 103TP0814X | Psychologist | Psychoanalysis | | | No |
| 6 | 103TP2701X | Psychologist | Group Psychotherapy | | | No |
| 7 | 106S00000X | Behavior Technician | | | | No |
| 8 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 9 | 251B00000X | Case Management | | | | No |
| 10 | 251S00000X | Community/Behavioral Health | | | | No |
| 11 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 12 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | 1092621 | TEXAS | No |
| 13 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | 281220 | ARIZONA | Yes |
