An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Licensed Psychiatric Technician | 167G00000X |
| Marriage & Family Therapist | 106H00000X |
* Indicates primary specialty
| NPI Number | 1356402085 |
| Credentials | MFT LPT |
| Entity | Individual |
| Enumeration date | 12/13/2006 |
| Last updated | 09/11/2025 - About 9 months ago |
| Sole proprietor1 | No |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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