MEDICARE: DAVID TERRASO

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	MSW010956	GA
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1437894300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID TERRASO

Provider Business Mailing Address
First Line	:	315 W PONCE DE LEON AVE STE 335
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2634
Country	:	US
Telephone Number	:	470-944-1662
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 W PONCE DE LEON AVE STE 335
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2634
Country	:	US
Telephone Number	:	404-944-1662
Fax Number	:

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

Provider Enumeration Date	:	05/04/2022
Last Update Date	:	02/27/2026

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Directions to “ DAVID TERRASO ” Practice Location

Language	Start Address	Practice Location

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