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PROVIDER TYPE CODEPROVIDER SPECIALTY CODETAXONOMY CODE074-Clinical Neuropsychologist103G00000X152-Counselor 101Y00000X155-Counselor, Addiction101YA0400X177-Counselor, Licensed Associate Professional (LAPC)101YP2500X190-Counselor, Licensed Professional Clinical (LPCC)101YP2500X194-Counselor, Professional101YP2500X403-Marriage & Family Therapist106H00000X191-Licensed Independent Clinical Social Worker (LICSW, LCSW)1041C0700X 050-Psychologist103T00000X425-Social Worker (LSW)104100000X011-Chiropractic Providers047-Chiropractor111N00000X019-D entists122300000X062-Endodontics1223E020 0X001-General Practice1223G0001X212- oral maxillofacial Surgery1223S0112X064-Orthodontics1223X04 00X063-Pedodontics (Pediatric Dentistry)1223P0221X065-Periodontics1223 P0300X066-Prosthodontics1223P0700X013-Di etary & Nutritional Service Providers056-Licensed Registered Dietician133V00000X411-Optician156FX1800 X088-Optometrist152W00000X130-Licensed Practical Nurse164W00000X127-Licensed Vocational Nurse164X00000X129-Registered Nurse163W00000X010-Behavioral Health & Social Service Providers015-Eye & Vision Service Providers016-Nursi
212-Oral Maxillofacial Surgery 204E00000X 214-Orthopedic Hand Surgery 207XS0106X 020-Orthopaedic Surgery 207X00000X 217-Otolarynology 207Y00000X 219-Pain Medicine 208VP0000X 108-Pediatric Allergy & Immunology 2080P0201X 412-Pediatric Anesthesiology 207LP3000X 221-Pediatric Cardiology 2080P0202X 222-Pediatric Dermatology 207NP0225X
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