Jewelya M Ianniciello, SUDP, LICSW is a
Counselor - Addiction (substance Use Disorder) based in Tacoma, Washington. Jewelya M Ianniciello is licensed to practice in Washington (license number CP00005115) and her current practice location is
5001 112th St E, Tacoma, Washington. She can be reached at her office (for appointments etc.) via phone at
(253) 460-0062.
NPI number for Jewelya M Ianniciello is 1891984498 and her current mailing address is 5001 112th St E, Tacoma, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1891984498.
Healthcare Provider's Profile
| Full Name | Jewelya M Ianniciello |
|---|
| Gender | Female |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 5001 112th St E, Tacoma, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1891984498
- Provider Enumeration Date: 10/18/2007
- Last Update Date: 01/05/2025
Medical Identifiers
Medical identifiers for Jewelya M Ianniciello such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1891984498 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | LW60174863 (Washington) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CP00005115 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jewelya M Ianniciello is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jewelya M Ianniciello, SUDP, LICSW
5001 112th St E,
Tacoma, WA 98446-5307
Ph: (253) 460-0062 | Jewelya M Ianniciello, SUDP, LICSW
5001 112th St E,
Tacoma, WA 98446-5307
Ph: (253) 460-0062 |
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