Provider Demographics
NPI:1326202672
Name:IRWIN, DELANO R (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DELANO
Middle Name:R
Last Name:IRWIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW TOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58763-9404
Mailing Address - Country:US
Mailing Address - Phone:701-627-4700
Mailing Address - Fax:701-627-4105
Practice Address - Street 1:404 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:NEW TOWN
Practice Address - State:ND
Practice Address - Zip Code:58763-9404
Practice Address - Country:US
Practice Address - Phone:701-627-4700
Practice Address - Fax:701-627-4105
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health