Individual provider · Type 1 NPI
Mary E. Iannuccillo, MSW
Clinical Social Worker · Portland, OR
Practice location
2250 NW Flanders St, Suite 103
Portland, OR 97210-3443
Fax (503) 657-8310
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 0759 (OR) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1023231982
Mary E. Iannuccillo, MSW's National Provider Identifier is 1023231982, issued on Apr 10, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Portland, OR. The record was last updated on Jul 8, 2007.