Provider Demographics
NPI:1760622393
Name:MICHALS, BERNARD (LCSW)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:
Last Name:MICHALS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:BERNARD
Other - Middle Name:
Other - Last Name:MICHALS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:140 MARINE VIEW AVE
Mailing Address - Street 2:#119
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2133
Mailing Address - Country:US
Mailing Address - Phone:858-481-5881
Mailing Address - Fax:760-487-1612
Practice Address - Street 1:140 MARINE VIEW AVE
Practice Address - Street 2:#119
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2133
Practice Address - Country:US
Practice Address - Phone:858-481-5881
Practice Address - Fax:760-487-1612
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-22
Last Update Date:2009-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.C.S.W. #75671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical