Provider Demographics
NPI:1376862136
Name:IRWIN, COURTNEY LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LYNN
Last Name:IRWIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 SAWTOOTH OAK ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7160
Mailing Address - Country:US
Mailing Address - Phone:501-520-6250
Mailing Address - Fax:
Practice Address - Street 1:177 SAWTOOTH OAK ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7160
Practice Address - Country:US
Practice Address - Phone:501-520-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR344L101YA0400X
AR2656-M104100000X
AR4054-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116399726Medicaid