Provider Demographics
NPI:1831135284
Name:IRWIN, MONETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:MONETTE
Middle Name:
Last Name:IRWIN
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:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27528-0187
Mailing Address - Country:US
Mailing Address - Phone:919-550-3323
Mailing Address - Fax:919-550-3379
Practice Address - Street 1:2076 NC HIGHWAY 42 W STE 220
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5303
Practice Address - Country:US
Practice Address - Phone:919-550-3323
Practice Address - Fax:919-550-3379
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0026581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12182OtherBCBS PROVIDER NUMBER
NC2872678BMedicare PIN
NC2872678AMedicare ID - Type UnspecifiedPROVIDER NUMBER