| Irwin Counseling Service Pllc | |
|
300 W Washington Ave Ste 210b Jackson MI 49201-2160 | |
| (517) 344-0913 | |
| (517) 905-6007 |
| Full Name | Irwin Counseling Service Pllc |
|---|---|
| Speciality | Counselor |
| Location | 300 W Washington Ave Ste 210b, Jackson, Michigan |
| Authorized Official Name and Position | Clint W Irwin (OWNER) |
| Authorized Official Contact | 5173440913 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irwin Counseling Service Pllc 300 W Washington Ave Ste 210b Jackson MI 49201-2160 Ph: (517) 344-0913 | Irwin Counseling Service Pllc 300 W Washington Ave Ste 210b Jackson MI 49201-2160 Ph: (517) 344-0913 |
| NPI Number | 1164946422 |
|---|---|
| Provider Enumeration Date | 07/28/2017 |
| Last Update Date | 03/15/2023 |
| Certification Date | 03/15/2023 |
| Medicare PECOS PAC ID | 3971975004 |
|---|---|
| Medicare Enrollment ID | O20230217001367 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164946422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Edward L Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477579266 PECOS PAC ID: 5496048266 Enrollment ID: I20160801002499 |
| Provider Name | Marcyan Elizabeth Irwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356766687 PECOS PAC ID: 8022408624 Enrollment ID: I20211213002484 |
| Provider Name | Samantha Marie Savage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457823023 PECOS PAC ID: 0749653475 Enrollment ID: I20230228002725 |
| Provider Name | Clint William Irwin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396054920 PECOS PAC ID: 6608248737 Enrollment ID: I20231214002994 |
| Provider Name | Geraldine San Juan-dunford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073119988 PECOS PAC ID: 0244680908 Enrollment ID: I20231221002334 |
| Provider Name | Sara Beg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720626534 PECOS PAC ID: 7517317019 Enrollment ID: I20231226000836 |
| Provider Name | Scott David Stark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215405360 PECOS PAC ID: 2668823469 Enrollment ID: I20240105001883 |
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