Individual
KAREN MARIE IRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LAC
Contact information
Practice address
1530 W 17TH ST, PUEBLO, CO 81003
(719) 544-3150
Mailing address
1530 W 17TH ST, PUEBLO, CO 81003-1558
(719) 544-3150
(816) 781-1111
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000976
CO
1041C0700X
Clinical Social Worker
2004019098
MO
1041C0700X
Clinical Social Worker
Primary
CSW.09924278
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13279718
—
MO
01
—
2004019098
LCSW
MO
01
—
ACD.0000976
LAC
CO
01
—
CSW.09924278
LCSW
CO
Enumeration date
02/09/2007
Last updated
05/15/2020
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