Healthcare Provider Details

I. General information

NPI: 1083337406
Provider Name (Legal Business Name): DAKOTA DRISCOLL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 AMSTERDAM AVE
NEW YORK NY
10031-4611
US

IV. Provider business mailing address

1157 MYRTLE AVE APT 2A
BROOKLYN NY
11206-6838
US

V. Phone/Fax

Practice location:
  • Phone: 540-808-9198
  • Fax:
Mailing address:
  • Phone: 540-808-9198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number126797-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: