Stacey Nadine Denafo, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

YS03200 Issued in NJ

Practice address

2300 New Rd
Suite 201
Northfield, NJ 08225-1466

Phone

(609) 407-7117

Fax

(609) 407-7110

NPI assigned

Nov 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1720355282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 NEW RD",
            "address_2": "SUITE 201",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251466",
            "telephone_number": "609-407-7117",
            "fax_number": "609-407-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 NEW RD",
            "address_2": "SUITE 201",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251466",
            "telephone_number": "609-407-7117",
            "fax_number": "609-407-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENAFO",
        "first_name": "STACEY",
        "middle_name": "NADINE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "YS03200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10654772",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE II",
            "identifier": "1669747549",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendra Lawson Davis, APN
• Kristen Davis
• Jamie Ann Debouno, NP-C
• Carmen M. Demareo, LCSW
• Lisa Demario, LCSW, LCADC
• Joan Elizabeth Dios, RN
• Katherine Ditmire
• Erik Doerr, LAC, NCC
• Donald C. Perry, D.D.S.
• Richard D. Douglas, OTR/L, CHT

• Speech-Language Pathologist in Northfield, NJ
• Providers in Northfield, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.