Provider Demographics
NPI:1346464948
Name:DELLAGIOVANNA, ALICIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:DELLAGIOVANNA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 KNOLLWOOD RD
Mailing Address - Street 2:APT. 2 L
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1325
Mailing Address - Country:US
Mailing Address - Phone:718-964-7362
Mailing Address - Fax:516-773-3695
Practice Address - Street 1:4516 251ST ST
Practice Address - Street 2:SUITE 204
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1333
Practice Address - Country:US
Practice Address - Phone:516-652-7716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075677-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical