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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 Providers015-Eye & Vision Service Providers016-Nursing Service Providers012-Dental Providers335-Cas

PROVIDER TYPE CODE PROVIDER SPECIALTY CODE TAXONOMY CODE 074-Clinical Neuropsychologist 103G00000X 152-Counselor 101Y00000X 155-Counselor, Addiction 101YA0400X

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