Individual
MICHAEL DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T, BSW
Contact information
Practice address
50 WEST HAWTHORNE AVE 2ND FLOOR, VALLEY STREAM, NY 11580-1158
(516) 569-6600
Mailing address
246 N RICHMOND AVE, MASSAPEQUA, NY 11758
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
35762
NY
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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