Provider Demographics
NPI:1629680749
Name:JIRINZU, IRENE (LCSW)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:JIRINZU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10802 LEGACY PARK DR APT 2212
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-9470
Mailing Address - Country:US
Mailing Address - Phone:210-362-4574
Mailing Address - Fax:
Practice Address - Street 1:12340 JONES RD STE 290
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3129
Practice Address - Country:US
Practice Address - Phone:832-756-2749
Practice Address - Fax:859-201-1151
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61470104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX394812701Medicaid
TX1629680749Medicaid