PROVIDER TYPE CODE PROVIDER SPECIALTY CODE …
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 Providers01
130-Licensed Practical Nurse 164W00000X 127-Licensed Vocational Nurse 164X00000X 129-Registered Nurse 163W00000X 010-Behavioral Health & ... 024-Plastic Surgery 208200000X 256-Plastic Surgery Hand Surgery 2082S0105X 257-Preventative Medicine/Occupational-Environmental Medicine 2083P0500X
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