Provider Demographics
NPI:1740520998
Name:IRIZARRY, BARBARA IVETTE (MSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:IVETTE
Last Name:IRIZARRY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:BARBARA
Other - Middle Name:IVETTE
Other - Last Name:IRIZARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:VILLAS CENTROAMERICANA 2010
Mailing Address - Street 2:10/0765
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-458-1052
Mailing Address - Fax:
Practice Address - Street 1:183 AVE DUNSCOMBE
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-2432
Practice Address - Country:US
Practice Address - Phone:787-831-5800
Practice Address - Fax:787-832-0740
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10930261QM0850X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health