Individual
MRS. BONNIE M. MCIRVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7096 E. SAN CRISTOBAL WAY, GOLD CANYON, AZ 85118-1838
(458) 205-8943
(458) 210-2788
Mailing address
3741 S. BRIGHTON LANE, GILBERT, AZ 85297-7636
(541) 954-9174
(458) 210-2788
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
101YM0800X
Mental Health Counselor
A2745
OR
101YM0800X
Mental Health Counselor
L2745
OR
1041C0700X
Clinical Social Worker
Primary
L6756
OR
Other
Enumeration date
10/03/2011
Last updated
09/13/2022
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