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1 Provider Type Provider Specialty Taxonomy Taxonomy Description Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Inpatient facility Acute Care Hospital Acute Care Hospital Acute Care Hospital Acute Care Hospital Acute Care Hospital Acute Care Hospital Acute Care Hospital Acute Care Hospital Private Psychiatric Hospital Medical Rehabilitation Hospital Medical Rehabilitation Hospital Residential Treatment Facility (JCAHO Certified) Hospital Inpatient Medical Rehab Unit Children s Specialty Emergency Room Arrangement 1 Emergency Room Arrangement 2 Extended Acute Psych Inpatient Unit Drug and Alcohol Rehabilitation Hospital Short Procedure Unit Short Procedure Unit 00000X 282N00000X 282NC0060X 282NC2000X 282NR13X 282NW00X X 2865M2000X 283Q00000X 283X00000X 283XC2000X 323P00000X 3Y00000X 282NC2000X 261QE0002X 261QE0002X 3R00000X X 261QA03X Hospital Units Epilepsy Unit Hospitals General Acute Care Hospital Hospitals General Acute Care Hospital Critical Access Hospitals General Acute Care Hospital Children Hospitals General Acute Care Hospital Rural Hospitals General Acute Care Hospital Women Hospitals Military Hospital Hospitals Military Hospital Military General Acute Care Hospital Hospitals Psychiatric Hospital Default specialty Code Hospitals Rehabilitation Hospital Default specialty Code Hospitals Rehabilitation Hospital Children Residential Treatment Facilities Psychiatric Residential Treatment Facility Hospital Unit Rehabilitation Unit Hospitals General Acute Care Hospital Children Emergency Care Emergency Care Hospital Unit Psychiatric Unit Hospitals Special Hospital Default specialty Code Ambulatory Surgical

2 Inpatient facility Inpatient facility Private Psychiatric Unit Public Psychiatric Hospital Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical 3R00000X 283Q00000X 261QA0005X 261QA0006X 261QA0600X 261QA03X 261QA3000X 261QB0400X 261QC0050X 261QC1500X 261QD0000X 261QD00X 261QE0002X 261QE0700X 261QE00X Hospital Unit Psychiatric Unit Hospitals Psychiatric Hospital Default specialty Code Default Specialty code Ambulatory Family Planning Facility Ambulatory Fertility Facility Adult Day Care Ambulatory Surgical Augmentative Communication Birthing Critical Access Hospital Community Health Dental Developmental Disabilities Emergency Care End Stage Renal Disease (ESRD) Treatment Endoscopies

3 Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical 261QF0050X 261QF0400X 261QG0250X 261QH00X 261QH0700X 261QI0500X 261QL0400X 261QM1000X 261QM1200X 261QM1300X 261QM2500X 261QM3000X 261QP04X 261QP05X 261QP00X 261QP2000X Family Planning Non Surgical Federally Qualified Health Center (FQHC) Genetics Health Service Hearing and Speech Infusion Therapy Lithotripsy Migrant Health Magnetic Resonance Imaging (MRI) Multi Specialty Medical Specialty Medically Fragile Infants and Children Day Care Public Health Federal Public Health State or Local Podiatric Physical Therapy

4 Inpatient facility 441 Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Hospital Based Medical Drug and Alcohol Rehab Unit 261QP2300X 261QP3300X 261QR0200X 261QR0206X 261QR0400X 261QR04X 261QR0404X 261QR0405X 261QR00X 261QS02X 261QS32X 261QU0200X 261QX00X 261QX0200X 261QX0203X X Primary Care Pain Radiology Radiology Mammography Rehabilitation Rehabilitation Comprehensive Outpatient Rehabilitation Facility (CORF) Rehabilitation Cardiac Facilities Rehabilitation Substance Use Disorder Recovery Care Oral and Maxillofacial Surgery Ophthalmologic Surgery Urgent Care Occupational Medicine Oncology Oncology Radiation Hospital Unit Rehabilitation Substance Use Disorder Unit

5 Ambulatory Surgical Center Ambulatory Surgical Center Ambulatory Surgical Center Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Extended Care Facility Rehabilitation Facility Ambulatory Surgical Center Ambulatory Surgical Center Ambulatory Surgical Center Nursing Facility Nursing Facility County Nursing Facility ICF/MR 8 Beds or Less ICF/MR 9 Beds or More State LTC Unit State Mental Retardation Center ICF/ORC Special Rehabilitation Nursing Facilities DMVA Nursing Facilities Based LTC Extended Care Facility Based LTC Extended Care Facility Comprehensive Outpatient Rehab Facility 261QA03X 261QE00X X 40N1450X X 5P00000X 5P00000X X X 3M00000X X 2865M2000X 282E00000X X 261QR04X Ambulatory Surgical Ambulatory Health Care Facilties Endoscopy Nursing and Custodial Care Facilities Skilled Nursing Facility Nursing and Custodial Care Facilities Skilled Nursing Facility Nursing Care Pediatric Nursing and Custodial Care Facilities Skilled Nursing Facility Nursing and Custodial Care Facilities Intermediate Care Facility Mentally Retarded Nursing and Custodial Care Facilities Intermediate Care Facility Mentally Retarded Nursing and Custodial Care Facilities Skilled Nursing Facility Nursing and Custodial Care Facilities Skilled Nursing Facility Nursing and Custodial Care Facilities Nursing Facility/Intermediate Care Facility Nursing and Custodial Care Facilities Skilled Nursing Facility Hospitals Military Hospital Hospitals Long Term Care Hospital Nursing and Custodial Care Facilities Skilled Nursing Facility Rehabilitation Comprehensive Outpatient Rehabilitation Facility (CORF)

6 Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Hospice Capitation Capitation Personal Emergency Response System Home Health Services Private Duty Nursing DME / Medical Supplies Personal Care - Agency Attendant Care/Personal Assistance Service Adult Day Care Homemaker Services Respite Care Home Based Hospice LTC CAP PCCM Targeted Outpatient Treatment Targeted Outpatient Treatment Targeted Outpatient Treatment Targeted Outpatient Treatment X 251E00000X 251E00000X 251E00000X 251E00000X 251E00000X 251E00000X 251E00000X 251E00000X 251G00000X 251T00000X 302R00000X 251K00000X 251S00000X 261QMX Suppliers Emergency Response System Companies Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Hospice Care Community Based Program of All Inclusive Care for the Elderly (PACE) Provider Organization Managed Care Organizations Health Maintenance Organization Public Health of Welfare Community/Behavioral Health Mental Health (Including community Mental Health Center)

7 Targeted Outpatient Treatment Targeted Outpatient Treatment Peer Specialist Peer Specialist Peer Specialist Peer Specialist Federally Qualified Health Center Federally Qualified Health Center Federally Qualified Health Center Rural Health Rural Health Independent Medical / Surgical Independent Medical / Surgical Independent Medical / Surgical Family Planning Family Planning 261QM50X 261QM55X 261QMX 261QM50X 261QR0400X 251E00000X 261QF0400X 261QR1300X 261QA03X 261QN2500X 261QA0005X Adult Mental Health Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adult Mental Health Rehabilitation Home Health Federally Qualified Health Center (FQHC) Rural Health Ambulatory Surgical Medical Specialty Ambulatory Family Planning Facility

8 Family Planning Family Planning Methadone Maintenance Methadone Maintenance Dental Dental Psychiatric Outpatient Psychiatric Outpatient Psychiatric Outpatient Psychiatric Outpatient Psychiatric Outpatient Psychiatric Outpatient Family Partnership Outpatient Drug and Alcohol Outpatient Drug and Alcohol Outpatient Drug and Alcohol 261QA0006X 261QF0050X 261QM2800X 261QD0000X 251K00000X 251S00000X 261QMX 261QM50X 261QM55X 261QF0400X 251K00000X 251S00000X Ambulatory Fertility Facility Family Planning Non-Surgical Methadone Dental Public Health of Welfare Community/Behavioral Health Mental Health (Including community Mental Health Center) Adult Mental Health Adolescent and Children Mental Health Federally Qualified Health Center (FQHC) Public Health or Welfare Community/Behavioral Health

9 Outpatient Drug and Alcohol Outpatient Drug and Alcohol Outpatient Drug and Alcohol FQHC Therapeutic Staff Support FQHC Therapeutic Staff Support FQHC Therapeutic Staff Support FQHC Mobile Therapy FQHC Mobile Therapy FQHC Mobile Therapy FQHC Behavioral Specialist Consultant FQHC Behavioral Specialist Consultant FQHC Behavioral Specialist Consultant FQHC Summer Therapeutic Activity Program (STAP) FQHC Summer Therapeutic Activity Program (STAP) FQHC Summer Therapeutic Activity Program (STAP) RHC Therapeutic Staff Support 261QMX 261QM50X 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X Mental Health (Including community Mental Health Center) Adult Mental Health Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health

10 RHC Therapeutic Staff Support RHC Therapeutic Staff Support RHC Mobile Therapy RHC Mobile Therapy RHC Mobile Therapy RHC Behavioral Specialist Consultant RHC Behavioral Specialist Consultant RHC Behavioral Specialist Consultant RHC Summer Therapeutic Activity Program (STAP) RHC Summer Therapeutic Activity Program (STAP) RHC Summer Therapeutic Activity Program (STAP) Psych Therapeutic Staff Support Psych Therapeutic Staff Support Psych Therapeutic Staff Support Psych Mobile Therapy Psych Mobile Therapy 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center)

11 Psych Mobile Therapy Psych Behavioral Specialist Consultant Psych Behavioral Specialist Consultant Psych Behavioral Specialist Consultant Psych Summer Therapeutic Activity Program (STAP) Psych Summer Therapeutic Activity Program (STAP) Psych Summer Therapeutic Activity Program (STAP) Pediatric Pediatric Pediatric Pediatric Pediatric Pediatric Obstetrics / Gynecology Obstetrics / Gynecology Obstetrics / Gynecology 261QM55X 261QMX 261QM55X 261QMX 261QM55X 363L00000X 363LP0200X 363LP0222X 363LP2300X 363L00000X Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Critical Care Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers

12 Obstetrics / Gynecology Obstetrics / Gynecology Obstetrics / Gynecology Family Health Family Health Family Health Family Health Family Health (Primary Care) (Primary Care) (Primary Care) (Primary Care) Family Home Health Family Home Health Family Home Health Family Home Health 363LA2200X 363LP2300X 363LX00X 363L00000X 363LF0000X 363LP2300X 363L00000X 363LP2300X 363L00000X 363LC1500X Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Obstetrics and Gynecology Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Family Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Community Health

13 Family Home Health Family Home Health Adult Health Adult Health Adult Health Adult Health Adult Health School School School School Family Planning Family Planning Family Planning Family Planning Family Planning 363LF0000X 363LP2300X 363L00000X 363LA2200X 363LP2300X 363L00000X 363LS0200X 363L00000X 363LA2200X 363LC1500X Assistants and Advanced Practice Nursing Providers Family Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers School Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Community Health

14 Family Planning Family Planning Family Planning Family Planning Gerontology Gerontology Gerontology Gerontology Gerontology Emergency Emergency Emergency Emergency Neonatal Neonatal Neonatal 363LF0000X 363LP2300X 363LW02X 363LX00X 363L00000X 363LG0600X 363LP2300X 363L00000X 363LC0200X 363L00000X Assistants and Advanced Practice Nursing Providers Family Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Womens Health Assistants and Advanced Practice Nursing Providers Obstetrics and Gynecology Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Gerontology Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Critical Care Medicine Assistants and Advanced Practice Nursing Providers

15 Neonatal Neonatal Neonatal Adult Psych Mental Health Adult Psych Mental Health Adult Psych Mental Health Adult Psych Mental Health Adult Psych Mental Health Adult Acute Care Adult Acute Care Adult Acute Care Adult Acute Care Adult Acute Care Pediatric Acute Chronic Pediatric Acute Chronic Pediatric Acute Chronic 363LN0000X 363LN0005X 363LP2300X 363L00000X 363LPX 363LP2300X 363L00000X 363LA2100X 363LP2300X 363L00000X Assistants and Advanced Practice Nursing Providers Neonatal Assistants and Advanced Practice Nursing Providers Neonatal Critical Care Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Psychiatric/Mental Health Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Acute Care Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers

16 Pediatric Acute Chronic Pediatric Acute Chronic Pediatric Critical Care Pediatric Critical Care Pediatric Critical Care Pediatric Critical Care Adult Cardiopulmonary Adult Cardiopulmonary Adult Cardiopulmonary Adult Cardiopulmonary Adult Cardiopulmonary Adult Surgical Adult Surgical Adult Surgical Adult Surgical Adult Surgical 363LP0200X 363LP2300X 363L00000X 363LP0222X 363L00000X 363LA2200X 363LP2300X 363L00000X 363LA2200X 363LP2300X Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Critical Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Primary Care

17 Adult Renal Metabolic Adult Renal Metabolic Adult Renal Metabolic Adult Renal Metabolic Adult Renal Metabolic Adult Critical Care Adult Critical Care Adult Critical Care Adult Critical Care Adult Critical Care Adult Neuroscience Adult Neuroscience Adult Neuroscience Adult Neuroscience Adult Neuroscience Adult Oncology 363L00000X 363LA2200X 363LP2300X 363L00000X 363LA2200X 363LP2300X 363L00000X 363LA2200X 363LP2300X Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Primary Care

18 Adult Oncology Adult Oncology Adult Oncology Adult Oncology Adult Preoperative Adult Preoperative Adult Preoperative Adult Preoperative Pediatric Oncology Pediatric Oncology Pediatric Oncology Pediatric Oncology Perinatal Perinatal Perinatal Perinatal 363L00000X 363LA2200X 363LP2300X 363L00000X 363LA2200X 363L00000X 363LP0200X 363L00000X 363LP00X Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Adult Health Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Perinatal

19 Womens Health Womens Health Womens Health Womens Health Womens Health Therapeutic Staff Support Therapeutic Staff Support Therapeutic Staff Support Mobile Therapy Mobile Therapy Mobile Therapy Behavioral Specialist Consultant Behavioral Specialist Consultant Behavioral Specialist Consultant Peer Specialist Peer Specialist 363L00000X 363LP2300X 363LW02X 363LPX 363LPX 363LPX 261QMX Assistants and Advanced Practice Nursing Providers Assistants and Advanced Practice Nursing Providers Primary Care Assistants and Advanced Practice Nursing Providers Womens Health Assistants and Advanced Practice Nursing Providers Psychiatric/Mental Health Assistants and Advanced Practice Nursing Providers Psychiatric/Mental Health Assistants and Advanced Practice Nursing Providers Psychiatric/Mental Health Mental Health (Including community Mental Health Center)

20 Peer Specialist Peer Specialist Psychiatric Outpatient Psychiatric Outpatient Psychiatric Outpatient Psychiatric Outpatient Psychiatric Outpatient Psychiatric Outpatient Community Mental Health Community Mental Health Community Mental Health Community Mental Health Community Mental Health Community Mental Health Licensed Outpatient Practitioner - MH Licensed Outpatient Practitioner - MH 261QM50X 261QR0400X 251K00000X 251S00000X 261QMX 261QM50X 261QM55X 251K00000X 251S00000X 261QMX 261QM50X 261QM55X 1Y00000X 1YA0400X Adult Mental Health Rehabilitation Public Health or Welfare Community/Behavioral Health Mental Health (including community Mental Health Center) Adult Mental Health Adolescent and Children Mental Health Public Health or Welfare Community/Behavioral Health Mental Health (including community Mental Health Center) Adult Mental Health Adolescent and Children Mental Health Counselor Counselor Addiction (Substance Use Disorder)

21 Licensed Outpatient Practitioner - MH Licensed Outpatient Practitioner - MH Licensed Outpatient Practitioner - MH Licensed Outpatient Practitioner - MH Licensed Outpatient Practitioner - MH Licensed Outpatient Practitioner - MH Licensed Outpatient Practitioner - MH Partial Psych Hospitalization Children Partial Psych Hospitalization Children Partial Psych Hospitalization Children Partial Psych Hospitalization Children Partial Psych Hospitalization Children Partial Psych Hospitalization Adult Partial Psych Hospitalization Adult Partial Psych Hospitalization Adult Partial Psych Hospitalization Adult 1YM00X 1YP2500X 103K00000X 103TH0004X X 106H00000X 225XM00X 251K00000X 251S00000X 261QMX 261QM55X 251K00000X 251S00000X 261QMX Counselor Mental Health Counselor Professional Behavioral Analyst Health Social Worker Marriage and Family Occupational Mental Health Public Health or Welfare Community/Behavioral Health Mental Health (Including Community Mental Health Center) Adolescent and Children Mental Health Public Health or Welfare Community/Behavioral Health Mental Health (Including Community Mental Health Center)

22 Partial Psych Hospitalization Adult Family Based Mental Health Family Based Mental Health Family Based Mental Health Family Based Mental Health Family Based Mental Health Licensed al Social Worker Licensed Social Worker Mental Health Crisis Intervention Mental Health Crisis Intervention Mental Health Crisis Intervention Mental Health Crisis Intervention Mental Health Crisis Intervention Mental Health OMHSAS Mental Health OMHSAS Mental Health OMHSAS 261QM50X 251K00000X 251S00000X 261QMX 261QM55X 1041C0700X X 251K00000X 251S00000X 261QMX 261QM50X 251K00000X 251S00000X Adult Mental Health Public Health or Welfare Community/Behavioral Health Ambulatory Health care Facilities Mental Health (Including Community Mental Health Center) Adolescent and Children Mental Health Social Worker al Social Worker Public Health or Welfare Community/Behavioral Health Mental Health (Including Community Mental Health Center) Adult Mental Health Public Health or Welfare Community/Behavioral Health

23 Mental Health OMHSAS Mental Health OMHSAS Marriage and Family Counselor Psychiatric Rehabilitation Psychiatric Rehabilitation Psychiatric Rehabilitation Psychiatric Rehabilitation Psychiatric Rehabilitation Mental Illness/Substance Abuse Professional I Mental Illness/Substance Abuse Professional II D and A Outpatient D and A Outpatient D and A Outpatient D and A Intensive Outpatient D and A Intensive Outpatient D and A Partial Hospitalization 261QMX 261QM50X 106H00000X 251K00000X 251S00000X 261QMX 261QM50X 1YA0400X 1YA0400X 1Y00000X 1YA0400X 1YP2500X 251K00000X 251S00000X 251K00000X Mental Health (Including Community Mental Health Center) Adult Mental Health Marriage and Family Public Health or Welfare Community/Behavioral Health Mental Health (Including Community Mental Health Center) Adult Mental Health Counselor Addiction (Substance Use Disorder) Counselor Addiction (Substance Use Disorder) Counselor Counselor Addiction (Substance Use Disorder) Counselor Professional Public Health or Welfare Community/Behavioral Health Public Health or Welfare

24 D and A Partial Hospitalization D and A Partial Hospitalization D and A Partial Hospitalization D and A Partial Hospitalization D and A Partial Hospitalization D and A Halfway House D and A Halfway House D and A Medically Monitored detoxification D and A Medically Monitored detoxification D and A Medically Monitored Residential Short Term D and A Medically Monitored Residential Short Term D and A Medically Monitored Residential Long Term D and A Medically Monitored Residential Long Term CARN-AP (Certd Addictions RN-Advanced Practice) Outpatient Drug and Alcohol Outpatient Drug and Alcohol 251S00000X 261QMX 261QM50X 261QM55X 251S00000X 261QR0405X 251S00000X 261QR0405X 251S00000X 261QR0405X 251S00000X 261QR0405X 364S00000X 251K00000X 251S00000X Community/Behavioral Health Mental Health (Including Community Mental Health Center) Adult Mental Health Adolescent and Children Mental Health Community/Behavioral Health Rehabilitation, Substance Use Disorder Community/Behavioral Health Rehabilitation, Substance Use Disorder Community/Behavioral Health Rehabilitation, Substance Use Disorder Community/Behavioral Health Rehabilitation, Substance Use Disorder Assistants and Advanced Practice Nursing Providers al Specialist Public Health or Welfare Community/Behavioral Health

25 Outpatient Drug and Alcohol Outpatient Drug and Alcohol Outpatient Drug and Alcohol Program Exception Autism Behavioral Specialist Autism Social Worker Autism Marriage and Family Autism Professional Counselor Autism Counseling Agency Autism Counseling Agency Part Psych Hosp Child Therapeutic Staff Support Part Psych Hosp Child Therapeutic Staff Support Part Psych Hosp Child Therapeutic Staff Support Part Psych Hosp Child Mobile Therapy Part Psych Hosp Child Mobile Therapy Part Psych Hosp Child Mobile Therapy 261QMX 261QR0405X 251S00000X 1Y00000X X 106H00000X 1Y00000X 251K00000X 251S00000X 261QMX 261QM55X 261QMX 261QM55X Mental Health (Including Community Mental Health Center) Rehabilitation, Substance Use Disorder Community/Behavorial Health Counselor Social Worker Marriage and Family Counselor Public Health or Welfare Community/Behavorial Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health

26 Part Psych Hosp Child Behavioral Specialist Consultant Part Psych Hosp Child Behavioral Specialist Consultant Part Psych Hosp Child Behavioral Specialist Consultant Part Psych Hosp Child (STAP) Part Psych Hosp Child (STAP) Part Psych Hosp Child (STAP) Part Psych Hosp Adult Therapeutic Staff Support Part Psych Hosp Adult Therapeutic Staff Support Part Psych Hosp Adult Therapeutic Staff Support Part Psych Hosp Adult Mobile Therapy Part Psych Hosp Adult Mobile Therapy Part Psych Hosp Adult Mobile Therapy Part Psych Hosp Adult Behavioral Specialist Consultant Part Psych Hosp Adult Behavioral Specialist Consultant Part Psych Hosp Adult Behavioral Specialist Consultant Part Psych Hosp Adult (STAP) 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health

27 Part Psych Hosp Adult (STAP) Part Psych Hosp Adult (STAP) Family Based MNTL HLTH Therapeutic Staff Support Family Based MNTL HLTH Therapeutic Staff Support Family Based MNTL HLTH Therapeutic Staff Support Family Based MNTL HLTH Mobile Therapy Family Based MNTL HLTH Mobile Therapy Family Based MNTL HLTH Mobile Therapy Family Based MNTL HLTH Behavioral Specialist Consultant Family Based MNTL HLTH Behavioral Specialist Consultant Family Based MNTL HLTH Behavioral Specialist Consultant Family Based MNTL HLTH (STAP) Family Based MNTL HLTH (STAP) Family Based MNTL HLTH (STAP) Therapeutic Staff Support Mobile Therapy 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 261QMX 261QM55X 251S00000X 251S00000X Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Mental Health (Including community Mental Health Center) Adolescent and Children Mental Health Community/Behavioral Health Community/Behavioral Health

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