Provider Demographics
NPI:1699007609
Name:AUCOIN, DOUGLAS CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:CHRISTOPHER
Last Name:AUCOIN
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 1:3911 CLEVELAND AVE # 635225
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3402
Mailing Address - Country:US
Mailing Address - Phone:619-343-4046
Mailing Address - Fax:
Practice Address - Street 1:3911 CLEVELAND AVE.
Practice Address - Street 2:#635225
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103
Practice Address - Country:US
Practice Address - Phone:619-343-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 247071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS 24707OtherCA BOARD OF BEHAVIORAL SCIENCES