Individual
ALYSSA NICOLE DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4020 LAKE WORTH RD, PALM SPRINGS, FL 33461-3918
(561) 444-3512
Mailing address
6161 ASTORIA DR, LAKE WORTH, FL 33463-7323
(917) 416-3858
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW21273
FL
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120762000
—
FL
Enumeration date
03/30/2023
Last updated
06/04/2024
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