A NPI is required for EVERYONE that provides a HIPAA Service - regardless of license or education level.
The NPI is YOURS not your employers, so dont forget your login info!
When you shift to private practice, you will use the SAME login - just adding information.
You will update your NPI as you move & change employers.
Change your taxonomy & license when necessary.
You are YOUR name - not your credentials. Ex: Sam Smith – NOT Dr Sam Smith LPC
A CAQH Profile is required for all licensed providers that will be contracting with Insurance & Government payers.
This is YOUR profile - not your employers. This follows you throughout your career.
You will update this every time you change anything: personal address, mailing address, employer, affiliations, license information, etc. This is the “master list” for insurances.
You must list your practice address - NOT virtual.
List YOURSELF as the contact / business / etc. The person you list is getting the emails - so make sure YOU get the emails. (rare exceptions)
For us – after you done & attestted - go to “home” > bottom RIGHT > click on “download application” > send us that PDF
Taxonomy is the numeric identifier for your service type / license.
MOST Private Practices are multi or single specialty - NOT a clinic/facility/center/agency. The selection for your individual (not practice) needs to match your license (as close as possible)
**This is just the reference guide** (full list is on the taxonomy website)
Some examples:
193400000X-Single Specialty Group
193200000X-Multi-Specialty Group
Mental Health Counselor - 101YM0800X
Professional Counselor - 101YP2500X
Marriage and Family Therapists - 106H00000X
Clinical Social Workers - 1041C0700X
Physician Assistant - 363A00000X
DORA / Your licensing Board
We use this website to pull the data we need, but this is the same data you will use to update your CAQH + NPPES profiles. Everything has to match!
ICD-10 & Your Diagnostic Tools
As of 2026, we are still using the ICD10 list. This is the list of diagnosis codes, the details, and if they are billable. If this list says “not billable” or “needs further specification” then that is what insurance is reporting (also, stay in your license lane).
You must follow these rules if you want to be reimbursed by the insurance company.
Diagnostic tools vary by provider type/practice model. You do need to use a tool or assessment to back up the diagnosis you are providing. If you are not qualified to administer the assessment, then you cannot do it.
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