Jean Ann Driscoll, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4015 Issued in ND

Practice address

715 N 40TH St Apt 105K
Grand Forks, ND 58203

Phone

(701) 317-6487

NPI assigned

Jun 19, 2007

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Forks, ND
  • NPI 1366496341

  Multi-Specialty, ND

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, MN, ND

  Medicare reassignment NPD
• Northeast Human Service Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Grand Forks, ND
  • NPI 1891808978
  NPD

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 31, 2023.

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1265637250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N 40TH ST APT 105K",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582038513",
            "telephone_number": "701-317-6487",
            "fax_number": "017-317-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N 40TH ST APT 105K",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58203",
            "telephone_number": "701-317-6487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 S 4th St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582014715",
            "country_code": "US",
            "telephone_number": "701-795-3000",
            "fax_number": "701-795-3050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "JEAN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23801",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "4015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Benoit Tano, LTD
• Drake Counseling Services
• Olivia Mary Drane, BS, CNA
• Rachel Dreibelbeis
• Grace Driscoll, DC
• Paul G Drown, PA
• Qin Du, MD
• Elizabeth Rae Dub, LAT, ATC, PT, DPT
• Nomuhle Sanelisiwe Dube, DDS
• Kari Anne Dubois, PHARMD

• All providers in Grand Forks, ND
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.