Peter Destefano, THERAPIST

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00377900 Issued in NJ

Practice address

13 Heather PL
Southampton, NJ 08088-1115

Phone

(640) 223-5172

NPI assigned

Nov 10, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1033089446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 HEATHER PL",
            "city": "SOUTHAMPTON",
            "state": "NJ",
            "postal_code": "080881115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 HEATHER PL",
            "city": "SOUTHAMPTON",
            "state": "NJ",
            "postal_code": "080881115",
            "telephone_number": "640-223-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "PETER",
        "credential": "THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00377900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Cupoli
• Ashlee Davidson
• Kelly Hayes Davis, RN
• Jenea Dawkins
• Angela Deklerk, OTR/L
• Nelly Dixon, ED.D., BCBA
• Catherine A Ensana, M.A.
• Maria Eleni Evgeniadis, OTR/L
• Fayez Mikhail, LLC
• Casey Ray Gillick, DPT

• Addiction (Substance Use Disorder) Counselor in Southampton, NJ
• Providers in Southampton, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.