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Olivia J Distefano , MS

Speech-Language Pathologist β€’ Stafford, VA

Active NPI 1235860578 Individual Practitioner Female Practitioner
Practice location in NPPES

2765 Richmond Hwy Ste 203
Stafford, VA 225548331

Call 5404465323 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2765 Richmond Hwy Ste 203

Stafford, VA 225548331

Telephone 5404465323
Organization at the Same NPPES Address or Phone
Coastline Therapy Group, Llc Facility NPI 1730681388

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Wilmington, NC. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2022

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Stafford and Virginia

73 active clinicians are listed under Speech-Language Pathologist with a practice address in Stafford, VA (4,943 in Virginia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Stafford

0% of these 73 clinicians have the CMS telehealth indicator.

1.4% of these 73 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-08-04
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES VA 2202011064

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES NC 30000795

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Virginia Department of Health Professions.
Look Up on State Board Site

Secondary Practice Locations

3901 Wrightsville Ave Ste 120

Wilmington, NC 284036256

Phone: 9106798385

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Alysia Clawson

Physical Therapist

NPI 1871947200

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location August 04, 2026

Registered at 2765 RICHMOND HWY STE 203, STAFFORD, VA 225548331 (Tel: 5404465323)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2026

Speech-Language Pathologist (license number reported to NPPES: VA 2202011064)

βœ…
NPI Profile Active June 27, 2022

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 27, 2022

Registered at 3901 WRIGHTSVILLE AVE STE 120, WILMINGTON, NC 284036256 (Tel: 9106798385)

πŸ“
Business Mailing Address (Initial Record) June 27, 2022

Registered at 3901 WRIGHTSVILLE AVE STE 120, WILMINGTON, NC 284036256 (Tel: 9106798385)

πŸ‘€
Provider Name / Credentials (Initial Record) June 27, 2022

Recorded as OLIVIA DISTEFANO, MS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 27, 2022

Speech-Language Pathologist (license number reported to NPPES: NC 30000795)

🟒
Initial NPI Registration & Enumeration June 17, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1235860578
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 17, 2022
Last Update: August 04, 2026
Sole Proprietor: Yes

Mailing Address

3901 Wrightsville Ave Ste 120

Wilmington, NC 284036256

Phone: 9106798385

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.