Provider Demographics
NPI:1467808568
Name:CLONTS, PAUL ANDREW (LCSW)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ANDREW
Last Name:CLONTS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 ENCINITAS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3773
Mailing Address - Country:US
Mailing Address - Phone:760-331-7879
Mailing Address - Fax:
Practice Address - Street 1:531 ENCINITAS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3773
Practice Address - Country:US
Practice Address - Phone:760-331-7879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87259101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health