Provider Demographics
NPI:1659301307
Name:DROUILHET, MICHAEL JOSEPH (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:DROUILHET
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 1:2945 HARDING ST
Mailing Address - Street 2:112
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1818
Mailing Address - Country:US
Mailing Address - Phone:760-720-0662
Mailing Address - Fax:760-931-0728
Practice Address - Street 1:2945 HARDING ST
Practice Address - Street 2:STE 112
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1818
Practice Address - Country:US
Practice Address - Phone:760-720-0662
Practice Address - Fax:760-931-0728
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 89911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW8991Medicare ID - Type UnspecifiedMEDICARE ID #