Provider Demographics
NPI:1093603441
Name:IRIS, MIRABELL (LPC)
Entity type:Individual
Prefix:
First Name:MIRABELL
Middle Name:
Last Name:IRIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 S 3RD ST # 221
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3618
Mailing Address - Country:US
Mailing Address - Phone:530-966-6240
Mailing Address - Fax:
Practice Address - Street 1:2811 CASTLEWOOD DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-7526
Practice Address - Country:US
Practice Address - Phone:530-966-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021567101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health