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NPI Code Detail

MEDICARE: DAVID M CORELLA LICSW

MEDICARE:   DAVID M CORELLA  LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1063018778
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID M CORELLA LICSW
Provider Business Mailing Address
First Line : 7511 GREENWOOD AVE N UNIT 4115
Second Line :
City : SEATTLE
State : WA
Zip : 98103-4627
Country : US
Telephone Number : 480-226-6962
Fax Number :
Provider Business Practice Location Address
First Line : 7511 GREENWOOD AVE N UNIT 4115
Second Line :
City : SEATTLE
State : WA
Zip : 98103-4627
Country : US
Telephone Number : 480-226-6962
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2020
Last Update Date : 07/09/2025

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Directions to “ DAVID M CORELLA LICSW” Practice Location

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