MEDICARE: AMY LYNN IRONS

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	101Y00000X	Counselor	LAC-23782	AZ

General Provider Information

NPI Number	:	1538037494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LYNN IRONS

Provider Business Mailing Address
First Line	:	4890 E WHITEHALL DR
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-5037
Country	:	US
Telephone Number	:	602-573-2023
Fax Number	:

Provider Business Practice Location Address
First Line	:	4890 E WHITEHALL DR
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-5037
Country	:	US
Telephone Number	:	602-573-2023
Fax Number	:

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

Provider Enumeration Date	:	10/23/2025
Last Update Date	:	10/23/2025

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