MEDICARE: IRISE COUNSELING SERVICE LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1619122009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRISE COUNSELING SERVICE LLC

Provider Business Mailing Address
First Line	:	2711 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-4105
Country	:	US
Telephone Number	:	313-657-5237
Fax Number	:

Provider Business Practice Location Address
First Line	:	2711 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-4105
Country	:	US
Telephone Number	:	313-657-5237
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CHLORINE F WIMBERLY
Credential	:	LCSW, MA
Telephone Number	:	313-657-5237

Provider Enumeration Date	:	11/26/2008
Last Update Date	:	01/03/2018

Similar Medicare Providers

1215525902 — AUGUST VOJDANI PA-C
Practice Location Address:

4588 PARADISE BLVD NW , MEDICARE ADVANTAGE CLINIC
ALBUQUERQUE, NM
87114-4105

Practice Phone: 505-998-1840
Practice Fax: 505-998-1841

1780579417 — CARE AT HOME MI LLC
Practice Location Address:

2751 E JEFFERSON AVE STE 400
DETROIT, MI
48207-4105

Practice Phone: 848-224-3500
Practice Fax:

1437374030 — DR. SUEZETTE OLAKER M.D.
Practice Location Address:

2711 E JEFFERSON AVE
DETROIT, MI
48207-4105

Practice Phone: 313-637-1600
Practice Fax:

1710164009 — JAMES DANIEL BAUER LLPC
Practice Location Address:

2761 E JEFFERSON AVE
DETROIT, MI
48207-4105

Practice Phone: 313-993-3964
Practice Fax:

1568611846 — GWENDOLYN D DEWALT RN, LBSW
Practice Location Address:

2761 E JEFFERSON AVE
DETROIT, MI
48207-4105

Practice Phone: 313-993-3964
Practice Fax: 313-993-1372

1407006257 — EMILY SCARLETT ORR MA
Practice Location Address:

2761 E JEFFERSON AVE
DETROIT, MI
48207-4105

Practice Phone: 313-993-3964
Practice Fax: 313-993-1372

Directions to “IRISE COUNSELING SERVICE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.