Psychologist (PBS (LIC/MED) Program Behavioral Health & Social 31 (IN-ST) 95 Only) 103T00000X Service Providers/Psychologist Psychologist (PBS (LIC/MED) Program and Behavioral Health & Social 31 (IN-ST) 96 X-Overs) 103T00000X Service Providers/Psychologist Podiatry - PODIATRIST Surgical Podiatric Medicine & Surgery 32 (IND & GP) 48 Chiropody 213E00000X Service Providers/Podiatrist ONLY ONLY 33 PROVIDER 92 PROVIDER NA NULL Audiologist (Billing Speech, Language and Hearing 34 (IN-ST) 64 231H00000X Service Providers/Audiologist LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc PHYSICAL THERAPIST Chiropractic 35 (IN-ST) 35 Chiropractor 111N00000X Providers/Chiropractor Respiratory, Developmental, PHYSICAL Indiv Rehabilitative & Restorative THERAPIST Physical Service Providers/Physical 35 (IN-ST) 65 Therapist 225100000X Therapist NOT 36 ASSIGNED NULL NA NULL Respiratory, Developmental, Rehabilitative & Restorative THERAPIST Service Providers/Occupational 37 (IN-ST) 74 Therapy 225X00000X Therapist SCHOOL SBHC - NP BSED - Part Time - HEALTH CTR less than 20 Ambulatory Health Care 38 (IN-ST) 7A hrs week 261Q00000X Facilities Clinic/Center SCHOOL SBHC - NP BSED - Full Time - HEALTH CTR 20 or more Ambulatory Health Care 38 (IN-ST) 7B hrs week 261Q00000X Facilities Clinic/Center SCHOOL SBHC - MD BSED - Part Time - HEALTH CTR less than 20 Ambulatory Health Care 38 (IN-ST) 7C hrs week 261Q00000X Facilities Clinic/Center SCHOOL SBHC - MD BSED - Full Time - HEALTH CTR 20 or more Ambulatory Health Care 38 (IN-ST) 7D hrs week 261Q00000X Facilities Clinic/Center
31 (LIC/MED) (IN-ST) 95 Psychologist (PBS Program Only) 103T00000X Behavioral Health & Social Service Providers/Psychologist 31 (LIC/MED) (IN-ST) 96 Psychologist (PBS Program and X-Overs) 103T00000X Behavioral Health & Social Service Providers/Psychologist 32 PODIATRIST (IND & GP) 48 Podiatry - Surgical Chiropody 213E00000X Podiatric Medicine & Surgery Service Providers/Podiatrist 33 ONLY PROVIDER 92 ONLY PROVIDER NA NULL 34 (IN-ST) 64 Audiologist (Billing 231H00000X Speech, Language and Hearing Service Providers/Audiologist LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc 35 PHYSICAL THERAPIST (IN-ST) 35 Chiropractor 111N00000X Chiropractic Providers/Chiropractor 35 PHYSICAL THERAPIST (IN-ST) 65 Indiv Physical Therapist 225100000X Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist 36 NOT ASSIGNED NULL NA NULL 37 THERAPIST (IN-ST) 74 Therapy 225X00000X Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist 38 SCHOOL BSED HEALTH CTR (IN-ST) 7A SBHC - NP - Part Time - less than 20 hrs week 261Q00000X Ambulatory Health Care Facilities Clinic/Center 38 SCHOOL BSED HEALTH CTR (IN-ST) 7B SBHC - NP - Full Time - 20 or more hrs week 261Q00000X Ambulatory Health Care Facilities Clinic/Center 38 SCHOOL BSED HEALTH CTR (IN-ST) 7C SBHC - MD - Part Time - less than 20 hrs week 261Q00000X Ambulatory Health Care Facilities Clinic/Center 38 SCHOOL BSED HEALTH CTR (IN-ST) 7D SBHC - MD - Full Time - 20 or more hrs week 261Q00000X Ambulatory Health Care Facilities Clinic/Center
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx