Active NPI
Marc Hanna Irwin, PH.D.
- Psychologist
- Farmington, NM
National Provider Identifier
1386951978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 251
- Practice address
- 851 Andrea Dr
Suite 4, Building E
Farmington, NM 87401-6726 - Phone
- (505) 324-5855
- NPI assigned
- Sep 3, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 251 | NM | Primary |
Addresses
Primary practice location
851 Andrea Dr
Suite 4, Building E
Farmington, NM 87401-6726
Mailing address
851 Andrea Dr
Suite 4, Building E
Farmington, NM 87401-6726
Phone (505) 324-5855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1386951978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "851 ANDREA DR",
"address_2": "SUITE 4, BUILDING E",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874016726",
"telephone_number": "505-324-5855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "851 ANDREA DR",
"address_2": "SUITE 4, BUILDING E",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874016726",
"telephone_number": "505-324-5855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "MARC",
"middle_name": "HANNA",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-03",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.