Provider Demographics
NPI:1033637228
Name:CIRELLA, MICHELE NICOLE (MSW, LSWAIC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:NICOLE
Last Name:CIRELLA
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8402 SPADA RD
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-6179
Mailing Address - Country:US
Mailing Address - Phone:516-395-0635
Mailing Address - Fax:
Practice Address - Street 1:120 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2956
Practice Address - Country:US
Practice Address - Phone:206-594-5887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61084884104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61084884OtherLICENSE NUMBER