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RAEGAN DISTASIO
NPI 1851143473
Counselor - Mental Health in Syracuse, NY

Active since April 05, 2024
1045 JAMES ST STE 100, SYRACUSE, NY 13203(315) 472-4471 Get Directions Write a Review

NPPES record last updated: April 5, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Raegan Distasio NPPES

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

RAEGAN DISTASIO (NPI 1851143473) is an individual mental health provider in Syracuse, New York and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1851143473
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameRAEGAN DISTASIO
Location Address1045 JAMES ST STE 100Syracuse, NY 13203-2758
Mailing Address501 Thayer RdFairport, NY 14450-9514 · (585) 472-1568
Phone(315) 472-4471
Sole ProprietorNo
Enumeration DateApril 5, 2024
NPPES CertifiedApril 5, 2024
✔ NPI 1851143473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1045 JAMES ST STE 100, Syracuse, NY 13203
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Other Providers at the Same Location NPPES 20

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

MS. HEIDI M ZIERVOGEL LMSW
Social Worker
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
MR. MARCIN ROBERT ZAK LMHC
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
CAITLIN BECKER
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
ADRIANA SOTOLONGO LMSW
Social Worker
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 425-1004
KAYLA CUNNINGHAM LMHC
Counselor
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
MARTA MULHOLLAND PLMHC
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
MAGGIE PRUSINOWSKI
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 424-1004
MISS LYNDSEY COURTNEY LADD FNP
Nurse Practitioner (Family)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471

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 Raegan Distasio's NPI number?

The NPI number for Raegan Distasio is 1851143473. It was assigned to this individual provider in the NPPES registry on April 5, 2024.

Where is Raegan Distasio located?

Raegan Distasio practices at 1045 James St Ste 100, Syracuse, NY 13203. The listed phone number is (315) 472-4471.

What is Raegan Distasio's specialty?

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

When was this NPI record last updated?

The NPPES record for Raegan Distasio was last updated on April 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.