Jeffrey Gianelli, LCSW
Individual provider Active NPI Clinical Social Worker · Modesto, CA
NPI 1922408848 · NPPES record last updated Jun 1, 2021
Key facts
- NPI
- 1922408848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW88604 (CA)
- Practice address
- 2101 Tenaya Dr
Modesto, CA 95354-3930 - Phone
- (209) 576-6766
- NPI assigned
- Aug 27, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 4, 2024 through Apr 4, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW88604 | CA | MD | Clinical Social Worker |
| 73872 | CA | MD | Community Health Registered Nurse |
| 88604 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeffrey Gianelli Licensed Clinical Social Work a Professional Corp | Clinical | Current |
Accepting new patients |
| Onward Leading, LLC | Current |
Accepting new patients |
Locations
313 Walnut St
Ste 111
Wilmington, NC 28401
Phone (910) 368-9981
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 73872 | CA | |
| Clinical Social Worker | 1041C0700X | LCSW88604 | CA | Yes |
Addresses
Primary practice location
2101 Tenaya Dr
Modesto, CA 95354-3930
Mailing address
908 Fourth St S
Carolina Beach, NC 28428-5231
Phone (209) 683-6207
Other providers in Modesto, CA
- Saif Ashfaq Ghole
- Jagmohan Ghotra
- Ambrish Singh Ghumman
- Nataliya Giagou
- Jennifer Rose Giambelluca
- Eric Le Giang
- Lisa Minh Nguyen Giang
- James Gibbons
- Gabriela Gibbs
- Barbara Nicole Gibson
All providers in Modesto, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.