| Doctor Name: | KATHE IRVINE |
| NPI Number: | 1194108464 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.S.W. |
| License Number: | 0077081 |
| Business Practice Address: | 8553 Urbandale Ave Urbandale, IA - 503224108 |
| Business Phone Number: | 5152744006 |
| Business Fax Number: | 5152555697 |
| Mailing Address: | 207 Caulder Ave, DES MOINES |
| State: | IA |
| Postal Code: | 503157612 |
| Phone Number: | 5155549866 |
| Fax Number: | |
| NPI Enumeration Date: | 07/06/2015 |
| NPI Last Update Date: | 07/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0077081 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |