Provider Demographics
NPI:1053367953
Name:IRISH, JOSEPH D (LCSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:IRISH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-5030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:284 MAIN ST
Practice Address - Street 2:SUITE 320
Practice Address - City:SCHOHARIE
Practice Address - State:NY
Practice Address - Zip Code:12157-2118
Practice Address - Country:US
Practice Address - Phone:518-295-8336
Practice Address - Fax:518-295-8724
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0385231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00555784Medicaid
NY53415GMedicare ID - Type Unspecified