Katherine Destefano, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW021790 Issued in PA

Practice address

502 N Blakely St
Dunmore, PA 18512-1943

Phone

(570) 342-8434

Fax

(570) 342-7446

NPI assigned

Aug 10, 2017

Sex

Female

Sole proprietor

No

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tiffany Griffiths Psy D and Associates IncGroup PAC ID 5496907776, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Tiffany Griffiths Psy D & Associates Inc

  • Clinical Psychologist
  • Dunmore, PA
  • NPI 1649507831

  PA, Social Worker

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669997649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 WYOMING AVE",
            "city": "EXETER",
            "state": "PA",
            "postal_code": "186431434",
            "telephone_number": "570-342-8434",
            "fax_number": "570-299-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N BLAKELY ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185121943",
            "telephone_number": "570-342-8434",
            "fax_number": "570-342-7446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185031604",
            "country_code": "US",
            "telephone_number": "570-348-6100 x3238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "470 Wyoming Ave",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "PA",
            "postal_code": "187043603",
            "country_code": "US",
            "telephone_number": "570-342-8434",
            "fax_number": "570-288-1084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1031 Main St",
            "address_purpose": "LOCATION",
            "city": "Peckville",
            "state": "PA",
            "postal_code": "184522103",
            "country_code": "US",
            "telephone_number": "570-342-8434",
            "fax_number": "570-291-4960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1251 Wyoming Ave",
            "address_purpose": "LOCATION",
            "city": "Exeter",
            "state": "PA",
            "postal_code": "186431434",
            "country_code": "US",
            "telephone_number": "570-342-8434",
            "fax_number": "570-299-2521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "644 Germantown Pike Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Lafayette Hill",
            "state": "PA",
            "postal_code": "194441619",
            "country_code": "US",
            "telephone_number": "570-342-8434",
            "fax_number": "570-299-2521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "406 N State St",
            "address_purpose": "LOCATION",
            "city": "Clarks Summit",
            "state": "PA",
            "postal_code": "184111062",
            "country_code": "US",
            "telephone_number": "570-342-8434",
            "fax_number": "570-342-7446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW134648",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicholas David Dodge, MD

• All providers in Dunmore, PA
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.