Provider Demographics
NPI:1750621306
Name:IRWIN, EMMA S (LMSW)
Entity type:Individual
Prefix:MS
First Name:EMMA
Middle Name:S
Last Name:IRWIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 KEIBEL ROAD
Mailing Address - Street 2:
Mailing Address - City:WHITNEY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:13862
Mailing Address - Country:US
Mailing Address - Phone:607-692-8241
Mailing Address - Fax:607-692-8297
Practice Address - Street 1:24 KEIBEL ROAD
Practice Address - Street 2:
Practice Address - City:WHITNEY POINT
Practice Address - State:NY
Practice Address - Zip Code:13862
Practice Address - Country:US
Practice Address - Phone:607-692-8241
Practice Address - Fax:607-692-8297
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055880104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker