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NPI Code Detail

MEDICARE: IRIS M CANALES LMSW

MEDICARE: IRIS M CANALES LMSW
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
1104100000XSocial Worker109459NY
2101YM0800XMental Health Counselor33233MD
31041C0700XClinical Social Worker33233MD
4101YM0800XMental Health Counselor109459NY
51041C0700XClinical Social Worker109459NY

General Provider Information

NPI Number : 1790383826
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRIS M CANALES LMSW
Provider Business Mailing Address
First Line : 1425 UNIVERSITY BLVD E STE 245
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20783-4646
Country : US
Telephone Number : 240-413-2767
Fax Number :
Provider Business Practice Location Address
First Line : 1425 UNIVERSITY BLVD E STE 245
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20783-4646
Country : US
Telephone Number : 240-413-2767
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2020
Last Update Date : 05/14/2026

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Directions to “ IRIS M CANALES LMSW” Practice Location

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