Individual provider · Type 1 NPI

Jewelya M. Ianniciello, SUDP, LICSW

Addiction (Substance Use Disorder) Counselor · Tacoma, WA

NPI number 1891984498 Active

Practice location

5001 112th St E
Tacoma, WA 98446-5307

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700XLW60174863 (WA)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCP00005115 (WA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1891984498

Jewelya M. Ianniciello, SUDP, LICSW's National Provider Identifier is 1891984498, issued on Oct 18, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Tacoma, WA. The record was last updated on Jan 5, 2025.