DOUGLAS P DISTEFANO LPC
NPI 1558072454
Counselor - Mental Health in Phoenix, AZ

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

Active since December 12, 2022PECOS Enrolled

1919 E THOMAS RD, PHOENIX, AZ 85016(602) 933-0414 Get Directions Write a Review

NPPES record last updated: August 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 28, 2023, Dec 12, 2022 (2 updates tracked since 2022).

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About Douglas P Distefano Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOUGLAS P DISTEFANO LPC (NPI 1558072454) is an individual mental health provider in Phoenix, Arizona, licensed in Arizona (LPC-21266) and active in the NPI registry since December 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558072454

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameDOUGLAS P DISTEFANOCredential: LPC

Location Address1919 E THOMAS RDPhoenix, AZ 85016-7710

Mailing Address2108 E Thomas Rd Ste 130Phoenix, AZ 85016-7761 · (602) 933-1813

Phone(602) 933-0414

Sole ProprietorNo

Enumeration DateDecember 12, 2022

Last NPPES UpdateAugust 28, 20232 updates tracked since enumeration

NPPES CertifiedAugust 28, 2023

✔ NPI 1558072454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in AZ · LPC-21266

1919 E THOMAS RD, Phoenix, AZ 85016

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Douglas P Distefano Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.