Provider Demographics
NPI:1316185986
Name:DRISCOLL, CAROL L (LMSW-CC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:L
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ALLEN RANGE RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-6612
Mailing Address - Country:US
Mailing Address - Phone:207-865-9207
Mailing Address - Fax:
Practice Address - Street 1:3 ALLEN RANGE RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-6612
Practice Address - Country:US
Practice Address - Phone:207-865-9207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC11530101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health