MEDICARE: JESSICA A ZUNIGA LCSW

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	CW017765	PA

General Provider Information

NPI Number	:	1619249497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA A ZUNIGA LCSW

Provider Business Mailing Address
First Line	:	PO BOX 746722
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6722
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 COTTMAN AVE STE 71
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1007
Country	:	US
Telephone Number	:	215-444-7505
Fax Number	:

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

Provider Enumeration Date	:	02/08/2012
Last Update Date	:	05/01/2025

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