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MARISA DISTEFANO LPC
NPI 1720546260
Counselor - Mental Health in Ridgewood, NJ

Active since March 04, 2019PECOS Enrolled
172 FRANKLIN AVE STE 4B, RIDGEWOOD, NJ 07450(201) 446-4669 Get Directions Write a Review

NPPES record last updated: December 27, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 27, 2024, Dec 16, 2024, Mar 4, 2019 (3 updates tracked since 2019).

About Marisa Distefano Lpc NPPES

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

MARISA DISTEFANO LPC (NPI 1720546260) is an individual mental health provider in Ridgewood, New Jersey, licensed in New Jersey (37PC00661500) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1720546260
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMARISA DISTEFANOCredential: LPC
Location Address172 FRANKLIN AVE STE 4BRidgewood, NJ 07450-3229
Mailing Address172 Franklin Ave Ste 4bRidgewood, NJ 07450-3229 · (201) 446-4669
Phone(201) 446-4669
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateMarch 4, 2019
Last NPPES UpdateDecember 27, 20243 updates tracked since enumeration
NPPES CertifiedDecember 27, 2024
✔ NPI 1720546260 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 NJ · 37PC00661500
172 FRANKLIN AVE STE 4B, Ridgewood, NJ 07450
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13633 Hill Rd Fl 2Parsippany, NJ 07054-1000 · Phone (973) 335-5525
Location 2422 Cedar Hill AveWyckoff, NJ 07481-2219 · Phone (201) 446-4669

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID4385150119
PECOS Enrollment IDI20250718004015
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.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BILJANA GREBINNIK
Counselor (Professional)
172 FRANKLIN AVE STE 4B
RIDGEWOOD, NJ 07450
Bergen County (201) 618-9725
MARISA P DISTEFANO LPC LLC
Counselor (Mental Health)
172 FRANKLIN AVE STE 4B
RIDGEWOOD, NJ 07450
Bergen County (201) 446-4669

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marisa Distefano's NPI number?

The NPI number for Marisa Distefano is 1720546260. It was assigned to this individual provider in the NPPES registry on March 4, 2019.

Where is Marisa Distefano located?

Marisa Distefano practices at 172 Franklin Ave Ste 4B, Ridgewood, NJ 07450. The listed phone number is (201) 446-4669.

What is Marisa Distefano's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Marisa Distefano enrolled in Medicare?

Yes. Marisa Distefano is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Marisa Distefano was last updated on December 27, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.