Jewelya M Ianniciello, MSW, CDP | |
3402 55th Ave Ne, Tacoma, WA 98422-3156 | |
(206) 406-1178 | |
Not Available |
Full Name | Jewelya M Ianniciello |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 3402 55th Ave Ne, Tacoma, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891984498 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | CP00005115 (Washington) | Secondary |
101YM0800X | Counselor - Mental Health | RC00042019 (Washington) | Primary |
Entity Name | Navos |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194728105 PECOS PAC ID: 4385545474 Enrollment ID: O20040120001086 |
Mailing Address | Practice Location Address |
---|---|
Jewelya M Ianniciello, MSW, CDP 3402 55th Ave Ne, Tacoma, WA 98422-3156 Ph: (206) 406-1178 | Jewelya M Ianniciello, MSW, CDP 3402 55th Ave Ne, Tacoma, WA 98422-3156 Ph: (206) 406-1178 |
Kenneth E Clifton, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431 Phone: 253-968-4631 | |
David Andrew Ryan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5410 N 44th St, Tacoma, WA 98407 Phone: 253-759-9544 | |
Leah Marie Bedker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5410 N 44th St, Tacoma, WA 98407 Phone: 253-759-9544 | |
Ms. Kimberly Noel Zacher, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1201 S Proctor St, Tacoma, WA 98405 Phone: 253-396-5800 Fax: 253-759-7008 | |
Mr. James Wesley Pogue Jr., MBA Counselor Medicare: Not Enrolled in Medicare Practice Location: 610 Yakima Ave, Tacoma, WA 98405 Phone: 253-396-5237 | |
Ms. Sarah Lisa Bennett, MA, LMHC Counselor Medicare: Medicare Enrolled Practice Location: 3021 6th Ave, Tacoma, WA 98406 Phone: 253-326-2816 | |
Barbara J Cook, AA Counselor Medicare: Not Enrolled in Medicare Practice Location: 514 S 13th St, Tacoma, WA 98402 Phone: 253-396-5000 Fax: 253-383-5548 |