Provider Demographics
NPI:1215073903
Name:DRISCOLL, ROSEMARY ELIZABETH (LPCC)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:ELIZABETH
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31792
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87594-1792
Mailing Address - Country:US
Mailing Address - Phone:505-795-9760
Mailing Address - Fax:505-989-1470
Practice Address - Street 1:460 SAINT MICHAELS DR
Practice Address - Street 2:SUITE 806
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7619
Practice Address - Country:US
Practice Address - Phone:505-992-0226
Practice Address - Fax:505-989-1470
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0067532101YA0400X, 101YM0800X
WALH00007836101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health