Provider Demographics
NPI:1114575933
Name:IRBY, GARRETT (ALC)
Entity Type:Individual
Prefix:MR
First Name:GARRETT
Middle Name:
Last Name:IRBY
Suffix:
Gender:M
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 DARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3007
Mailing Address - Country:US
Mailing Address - Phone:205-966-8743
Mailing Address - Fax:
Practice Address - Street 1:2109 DARLINGTON ST
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3007
Practice Address - Country:US
Practice Address - Phone:205-966-8743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2712103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling