Courtney Defeo, CASAC-T

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

268111 Issued in NY

Practice address

770 Grand Blvd
Suite 17
Deer Park, NY 11729-5750

Phone

(631) 392-4357

Fax

(631) 392-4358

NPI assigned

Feb 23, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Behavioral Enhancement & Substance Abuse Medicine Treatment PLLC

  • Community/Behavioral Health Agency
  • Deer Park, NY
  • NPI 1346680071
  NPD (past)

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1922467604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 GRAND BLVD",
            "address_2": "SUITE 17",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295750",
            "telephone_number": "631-392-4357",
            "fax_number": "631-392-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 GRAND BLVD",
            "address_2": "SUITE 17",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295750",
            "telephone_number": "631-392-4357",
            "fax_number": "631-392-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFEO",
        "first_name": "COURTNEY",
        "credential": "CASAC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "268111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deer Park Physical Therapy & Chiropractic
• Deer Park Physical Therapy and Chiropractic PLLC
• Deer Park PT & Pta Physical Therapy & Rehabilitation, PLLC
• Deer Park PT, Family Health NP and Chiropractic PLLC
• Deer Park Ufsd
• Tracy Dekhtyar, RPA-C
• Joseph Del Valle, CASAC
• Julius Dela Cruz
• Maria Delcid
• Nora Delcid

• All providers in Deer Park, NY
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.