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General NPI Number Information
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NPI Number | 1497226732
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Entity Type | Individual
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Provider Name | ALYSSA FAELLA-AVERSA MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 101 ELLIOTT AVE W STE 500
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City | SEATTLE
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State | WA
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Zip | 98119-4292
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Country | US
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Telephone | 206-708-6432
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Fax |
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Provider Business Mailing Address
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Address Line | 3750 SW 100TH ST
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City | SEATTLE
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State | WA
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Zip | 98146-3633
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Country | US
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Telephone | 206-573-8255
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SWI.LW.61166866
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License Number State | WA
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