Marisa Distefano, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00661500 Issued in NJ

Practice address

172 Franklin Ave Ste 4B
Ridgewood, NJ 07450-3229

Phone

(201) 446-4669

NPI assigned

Mar 4, 2019

Sex

Female

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

Enrolled in NJ

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

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Marisa P Distefano LPC LLC

  • Mental Health Counselor
  • Ridgewood, NJ
  • NPI 1194532861
  Medicare reassignment NPD Authorized official
• A New Horizon Counseling & Psychotherapy Center

  • Mental Health Counselor
  • Parsippany, NJ
  • NPI 1093903841
  NPD (past)

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1720546260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 FRANKLIN AVE STE 4B",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503229",
            "telephone_number": "201-446-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 FRANKLIN AVE STE 4B",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503229",
            "telephone_number": "201-446-4669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3633 Hill Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Parsippany",
            "state": "NJ",
            "postal_code": "070541000",
            "country_code": "US",
            "telephone_number": "973-335-5525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 Cedar Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Wyckoff",
            "state": "NJ",
            "postal_code": "074812219",
            "country_code": "US",
            "telephone_number": "201-446-4669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "MARISA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00661500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louise Digia Levenshus, DC
• Patricia Dignam
• Anthony Dimitrion, LMSW
• Thomas Lee Dimitry, PH.D.
• Joseph John Diorio Jr., M.D.
• Ruthellen Grace Dixon, OTR
• Ismar Dizdarevic, M.D.
• Igor Dmytrienko, MD
• Keith F Dockery, M.D.
• Kristin Doherty, LPC

• Mental Health Counselor in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.