Active NPI
Elizabeth Heard Driscoll, LCSW-R, CGP
- Clinical Social Worker
- Rochester, NY
National Provider Identifier
1093844425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- RO56764-1
- Practice address
- 25 Canterbury Rd
Suite 306
Rochester, NY 14607-3403 - Phone
- (585) 737-0505
- Fax
- (585) 442-5971
- NPI assigned
- Mar 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | RO56764-1 | NY | Primary |
Addresses
Primary practice location
25 Canterbury Rd
Suite 306
Rochester, NY 14607-3403
Mailing address
20 Bay Colony Dr
Pittsford, NY 14534-3148
Phone (585) 737-0505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2018 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RO56764-1 | NY | MD | Clinical Social Worker |
| 056764 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093844425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 BAY COLONY DR",
"city": "PITTSFORD",
"state": "NY",
"postal_code": "145343148",
"telephone_number": "585-737-0505",
"fax_number": "585-442-5971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 CANTERBURY RD",
"address_2": "SUITE 306",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146073403",
"telephone_number": "585-737-0505",
"fax_number": "585-442-5971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRISCOLL",
"first_name": "ELIZABETH",
"middle_name": "HEARD",
"credential": "LCSW-R, CGP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "RO56764-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.