MEDICARE: ERICA DELLA JACONO

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	CSW008986	GA
2	1041C0700X	Clinical Social Worker	092756	NY

General Provider Information

NPI Number	:	1851772982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA DELLA JACONO

Provider Business Mailing Address
First Line	:	191 PEACHTREE ST NE STE 1400
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-1749
Country	:	US
Telephone Number	:	866-968-6342
Fax Number	:

Provider Business Practice Location Address
First Line	:	191 PEACHTREE ST NE STE 1400
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-1749
Country	:	US
Telephone Number	:	866-968-6342
Fax Number	:

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

Provider Enumeration Date	:	06/15/2015
Last Update Date	:	04/16/2025

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Directions to “ ERICA DELLA JACONO ” Practice Location

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