1457845406 NPI number — LOU IRWIN LCSW LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457845406 NPI number — LOU IRWIN LCSW LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOU IRWIN LCSW LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457845406
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 56266
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70055-6266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-837-7474
Provider Business Mailing Address Fax Number:
504-828-8814

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
804 N CAUSEWAY BLVD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70001-5364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-837-7474
Provider Business Practice Location Address Fax Number:
504-828-8814
Provider Enumeration Date:
06/21/2018

Additional Information

Authorized Official

Authorized Official Last Name:
IRWIN
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
CLINT
Authorized Official Title or Position:
CLINICAL SOCIAL WORKER--SOLE MEMBER
Authorized Official Telephone Number:
504-837-7474

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  1593 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1593 . This is a "LICENSED CLINICAL SOCIAL WORKER" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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