Provider Demographics
NPI:1578633640
Name:DRIGGS, HAROLD JOHN (MSW LICSW)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:JOHN
Last Name:DRIGGS
Suffix:
Gender:M
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:H
Other - Last Name:DRIGGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW LICSW
Mailing Address - Street 1:1678 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-1949
Mailing Address - Country:US
Mailing Address - Phone:651-699-4573
Mailing Address - Fax:
Practice Address - Street 1:1678 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-1949
Practice Address - Country:US
Practice Address - Phone:651-699-4573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1701104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker