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General NPI Number Information
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NPI Number | 1619542578
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Entity Type | Individual
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Provider Name | JAMIE ISAAC IRWIN LMSW
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Gender | Male
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 900 PHILADELPHIA PIKE
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City | WILMINGTON
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State | DE
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Zip | 19809-2280
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Country | US
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Telephone | 302-797-1233
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Fax |
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Provider Business Mailing Address
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Address Line | 1908 KYNWYD RD
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City | WILMINGTON
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State | DE
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Zip | 19810-3842
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Country | US
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Telephone | 302-507-4748
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW136352
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | Q3-0010450
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License Number State | DE
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