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General NPI Number Information
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NPI Number | 1902391378
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Entity Type | Individual
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Provider Name | MELANIE C DRISCOLL LLMSW
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Gender | Female
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 5500 AUTO CLUB DR STE 350
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City | DEARBORN
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State | MI
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Zip | 48126-2779
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Country | US
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Telephone | 313-217-2000
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Fax | 313-217-2090
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Provider Business Mailing Address
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Address Line | 18224 W 12 MILE RD APT 304
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2667
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Country | US
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Telephone | 248-938-5162
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801116258
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License Number State | MI
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