Provider Demographics
NPI:1093844425
Name:DRISCOLL, ELIZABETH HEARD (LCSW-R, CGP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HEARD
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:LCSW-R, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BAY COLONY DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3148
Mailing Address - Country:US
Mailing Address - Phone:585-737-0505
Mailing Address - Fax:585-442-5971
Practice Address - Street 1:25 CANTERBURY RD
Practice Address - Street 2:SUITE 306
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-3403
Practice Address - Country:US
Practice Address - Phone:585-737-0505
Practice Address - Fax:585-442-5971
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO56764-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical