Individual provider Active NPI

Stephen J. Defino, LCPC

  • Mental Health Counselor
  • Columbia, MD
National Provider Identifier
1457746943
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC6090 Issued in MD
Practice address
9030 Route 108
Suite a
Columbia, MD 21045-1990
Phone
(410) 740-1901
Fax
(410) 740-8237
NPI assigned
Apr 1, 2015
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC6090 MD Primary

Addresses

Primary practice location

9030 Route 108
Suite a
Columbia, MD 21045-1990

Mailing address

9030 Route 108
Suite a
Columbia, MD 21045-1990
Phone (410) 740-1901

Other practice location 1

13215 Brook Lane
Hagerstown, MD 21742-1514
Phone (301) 733-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC6090MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1457746943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 ROUTE 108",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451990",
            "telephone_number": "410-740-1901",
            "fax_number": "410-740-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 ROUTE 108",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451990",
            "telephone_number": "410-740-1901",
            "fax_number": "410-740-8237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13215 Brook Lane",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217421514",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFINO",
        "first_name": "STEPHEN",
        "middle_name": "J.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC6090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.