Individual
MICHAEL EMORY DRISCOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LP
Contact information
Practice address
4027 COUNTY ROAD 25, ST LOUIS PARK, MN 55416
(612) 925-6033
(612) 925-8496
Mailing address
4240 PARK GLEN RD, ST LOUIS PARK, MN 55416-5427
(612) 925-6033
(612) 925-8496
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2933
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106274
UCARE
MN
01
—
411425197
CIGNA BEHAVIORAL HEALTH
MN
05
—
553725800
—
MN
01
—
5H251DR
BCBS
MN
01
—
62515684
MEDICA CHOICE
MN
01
—
94376
OPTUM
MN
01
—
HP19956
HEALTHPARTNERS
MN
Enumeration date
11/01/2006
Last updated
02/15/2019
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