Individual provider Active NPI

Christine Rene Drouillard, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1104075225
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW - 28519 Issued in ID
Practice address
910 Main St
Sonna BLDG, Suite 231
Boise, ID 83702-5720
Phone
(208) 283-8362
NPI assigned
Sep 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW - 28519 ID Primary

Addresses

Primary practice location

910 Main St
Sonna BLDG, Suite 231
Boise, ID 83702-5720

Mailing address

411 Oak St
Cinncinatti, OH 45219
Phone (208) 283-8362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW - 28519IDMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1104075225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 OAK ST",
            "city": "CINNCINATTI",
            "state": "OH",
            "postal_code": "45219",
            "telephone_number": "208-283-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 MAIN ST",
            "address_2": "SONNA BLDG, SUITE 231",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025720",
            "telephone_number": "208-283-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROUILLARD",
        "first_name": "CHRISTINE",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW - 28519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.