Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jewelya M Ianniciello, SUDP, LICSW

Individual provider Clinical Social Worker · NPI 1891984498

Jewelya M Ianniciello, SUDP, LICSW is a Clinical Social Worker in Tacoma, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2007
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

5001 112th St E
Tacoma, WA 98446-5307
Phone: (253) 460-0062
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CP00005115 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence LW60174863 (WA)

Record details

NPI number1891984498
Entity typeIndividual (Type 1)
GenderFemale
Credentials SUDP , LICSW
Sole proprietorYes
NPI enumeratedOctober 18, 2007
Last updated in NPPESJanuary 5, 2025
Certification dateJanuary 5, 2025

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