Provider Demographics
NPI:1578754016
Name:DRUMM, THOMAS CARL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:CARL
Last Name:DRUMM
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:PO BOX 492277
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-2277
Mailing Address - Country:US
Mailing Address - Phone:808-989-3784
Mailing Address - Fax:
Practice Address - Street 1:56 WAIANUENUE AVE
Practice Address - Street 2:SUITE # 208
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2474
Practice Address - Country:US
Practice Address - Phone:808-989-3784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI33811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical