MEDICARE: MICHELLE ROSE YANNIELLO LICSW, LCSW, CCFC

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
1	1041C0700X	Clinical Social Worker	0904012900	VA
2	1041C0700X	Clinical Social Worker	LC50082737	DC
3	101YM0800X	Mental Health Counselor	29192	DC

General Provider Information

NPI Number	:	1477015451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ROSE YANNIELLO LICSW, LCSW, CCFC

Provider Business Mailing Address
First Line	:	1109 M ST NW APT 8
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-4371
Country	:	US
Telephone Number	:	631-921-3440
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 G ST NW STE 800
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-6705
Country	:	US
Telephone Number	:	646-941-7645
Fax Number	:	929-596-7897

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	11/19/2025

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