Provider Demographics
NPI:1720266687
Name:DRISCOLL, ELLIOTT J (LCSW)
Entity type:Individual
Prefix:MR
First Name:ELLIOTT
Middle Name:J
Last Name:DRISCOLL
Suffix:
Gender:M
Credentials:LCSW
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Mailing Address - Street 1:8501 LA SALLE ROAD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286
Mailing Address - Country:US
Mailing Address - Phone:410-337-7772
Mailing Address - Fax:410-337-8729
Practice Address - Street 1:8501 LA SALLE RD
Practice Address - Street 2:SUITE 115
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-337-7772
Practice Address - Fax:410-337-8729
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-03
Last Update Date:2016-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ44SC053404001041C0700X
NYR059937-11041C0700X
MD147801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical