MEDICARE: HEATHER KAY IRBY LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH22997	FL

General Provider Information

NPI Number	:	1598476970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER KAY IRBY LMHC

Provider Business Mailing Address
First Line	:	1820 HILLCREST AVE
Second Line	:
City	:	LAKE WORTH BEACH
State	:	FL
Zip	:	33461-6042
Country	:	US
Telephone Number	:	321-439-1497
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 HILLCREST AVE
Second Line	:
City	:	LAKE WORTH BEACH
State	:	FL
Zip	:	33461-6042
Country	:	US
Telephone Number	:	321-439-1497
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2022
Last Update Date	:	02/05/2025

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