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 | 103TA0400X | Psychologist | Addiction (Substance Use Disorder) | | | Yes |
| 2 | 103TM1800X | Psychologist | Intellectual and Developmental Disabilities | | | No |
| 3 | 146L00000X | Emergency Medical Technician, Paramedic | | | | No |
| 4 | 251S00000X | Community/Behavioral Health | | | | No |
| 5 | 224ZF0002X | Occupational Therapy Assistant | Feeding, Eating & Swallowing | | | No |
| 6 | 2251G0304X | Physical Therapist | Geriatrics | | | No |
| 7 | 225XF0002X | Occupational Therapist | Feeding, Eating & Swallowing | | | No |
| 8 | 225XP0019X | Occupational Therapist | Physical Rehabilitation | | | No |
| 9 | 101YM0800X | Counselor | Mental Health | | | No |
| 10 | 103K00000X | Behavior Analyst | | | | No |
| 11 | 103TC2200X | Psychologist | Clinical Child & Adolescent | | | No |
| 12 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 13 | 273R00000X | Psychiatric Unit | | | | No |
| 14 | 315D00000X | Hospice, Inpatient | | | | No |
| 15 | 261QC1500X | Clinic/Center | Community Health | | | No |
