Olivia J Distefano, MS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202011064 Issued in VA

Practice address

2765 Richmond Hwy Ste 203
Stafford, VA 22554-8331

Phone

(540) 446-5323

NPI assigned

Jun 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastline Therapy Group, LLC

  • Speech-Language Pathologist
  • Wilmington, NC
  • NPI 1730681388
  NPD
• Fleming Therapy Services, LLC

  dba Ivyrehab

  • Speech-Language Pathologist
  • Stafford, VA
  • NPI 1194925818
  NPD (past)
• Coastal Speech and Reading Center

  • Speech-Language Pathologist
  • Lumberton, NC
  • NPI 1649626466
  NPD (past)

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1235860578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 WRIGHTSVILLE AVE STE 120",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036256",
            "telephone_number": "910-679-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 RICHMOND HWY STE 203",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548331",
            "telephone_number": "540-446-5323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Wrightsville Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284036256",
            "country_code": "US",
            "telephone_number": "910-679-8385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "OLIVIA",
        "middle_name": "J",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202011064",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30000795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rochelle Dickerson
• Rebecca Diehl
• Joseph Robert Dietz Jr., REGISTERED NURSE
• Digitrace Care Services Inc (SleepMed)
• Siyuan Ding
• Divine Favour Healthcare LLC
• Divinity Healthcare LLC
• Divinus Integrated Care, Inc
• Christina Jean Dixon, OD
• Kevin Lee Dixon, OD

• Speech-Language Pathologist in Stafford, VA
• Providers in Stafford, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.