Provider Demographics
NPI:1184942245
Name:DRAPER, HAROLD STEPHEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:STEPHEN
Last Name:DRAPER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:HAROLD
Other - Middle Name:STEPHEN
Other - Last Name:DRAPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1015 12TH ST
Mailing Address - Street 2:STE.5
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-0838
Mailing Address - Country:US
Mailing Address - Phone:209-345-8966
Mailing Address - Fax:209-522-2993
Practice Address - Street 1:1015 12TH ST
Practice Address - Street 2:STE.5
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-0838
Practice Address - Country:US
Practice Address - Phone:209-345-8966
Practice Address - Fax:209-522-2993
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS211111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical