Anthony Defazio, MA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Wall, NJ
NPI 1962850198 · NPPES record last updated Mar 7, 2017
Key facts
- NPI
- 1962850198
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 1540 Rte 138 Ste 202
Wall, NJ 07719-3765 - Phone
- (732) 984-1263
- Fax
- (732) 515-9159
- NPI assigned
- May 27, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anthony Defazio, Lcadc LLC | Current | Accepting new patients |
Locations
1540 State Route 138
Ste 201
Wall Township, NJ 07719
Phone (732) 280-0020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
1540 Rte 138 Ste 202
Wall, NJ 07719-3765
Mailing address
1540 RT 138 Suite 202
Wall, NJ 07719
Phone (732) 984-1263
Other providers in Wall, NJ
- Susan Jane Curley
- Brian Daniel D'Allura
- Stephanie D'Allura
- Dallura Eye Care
- Debra S Gluck MSW LCSW LLC
- Digital Diagnostics, Inc.
- Iris Dubetsky
- Alexis Duplak
- Easter Seals New Jersey
- Easter Seals New Jersey
All providers in Wall, NJ · Addiction (Substance Use Disorder) Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.