Provider Demographics
NPI:1124632641
Name:IRWIN, LIAM BRIAN (LMSW)
Entity type:Individual
Prefix:MR
First Name:LIAM
Middle Name:BRIAN
Last Name:IRWIN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 MARTINDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-1727
Mailing Address - Country:US
Mailing Address - Phone:518-932-5328
Mailing Address - Fax:
Practice Address - Street 1:15 BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-1001
Practice Address - Country:US
Practice Address - Phone:518-747-2994
Practice Address - Fax:518-747-2996
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1100951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical