Provider Demographics
NPI:1770793903
Name:DRISCOLL, NOELLA MARGUERITE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:NOELLA
Middle Name:MARGUERITE
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 ELIZABETH LN
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3646
Mailing Address - Country:US
Mailing Address - Phone:703-978-5293
Mailing Address - Fax:
Practice Address - Street 1:1901 PENNSYLVANIA AVE NW
Practice Address - Street 2:602
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3405
Practice Address - Country:US
Practice Address - Phone:202-257-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3024711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical