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NPI Code Detail

MEDICARE: JILLIAN IRWIN LMFT

MEDICARE: JILLIAN IRWIN LMFT
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
1106H00000XMarriage & Family Therapist
2106H00000XMarriage & Family TherapistLMFT-15682AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679908685
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN IRWIN LMFT
Provider Business Mailing Address
First Line : 3910 S RURAL RD
Second Line : SUITE J
City : TEMPE
State : AZ
Zip : 85282-5581
Country : US
Telephone Number : 480-317-9868
Fax Number : 480-317-9867
Provider Business Practice Location Address
First Line : 8705 E MCDOWELL RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85257-3909
Country : US
Telephone Number : 480-882-4545
Fax Number : 480-946-6997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2013
Last Update Date : 03/20/2023

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