Bonnie M. McIrvin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L6756 Issued in OR

Practice address

7096 E. San Cristobal Way
Gold Canyon, AZ 85118-1838

Phone

(458) 205-8943

Fax

(458) 210-2788

NPI assigned

Oct 3, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Geomancie Promise LLC With Hellinger Systemic Constellations

  • Clinical Social Worker
  • Gold Canyon, AZ
  • NPI 1962041889

  OR

  Medicare reassignment NPD Authorized official
• Addiction Counseling and Education Services Inc.

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1780712851

  Addiction (Substance Use Disorder)

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1487938957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 S. BRIGHTON LANE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977636",
            "telephone_number": "541-954-9174",
            "fax_number": "458-210-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7096 E. SAN CRISTOBAL WAY",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851181838",
            "telephone_number": "458-205-8943",
            "fax_number": "458-210-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCIRVIN",
        "first_name": "BONNIE",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "A2745",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L2745",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Aaron Loui
• Jonathan George Lovell, DMD
• Mary C. Marcantel, N.D.
• Lisa M Marshall, HAD
• April McCollough, LAC
• McMahon, DDS, Inc
• Pamela Ann McMahon, DDS
• Aaron Udell Miller, D.C.
• Linda Carol Newell, M.D.
• Peralta Urgent Care

• Clinical Social Worker in Gold Canyon, AZ
• Providers in Gold Canyon, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.