BRONSON DESTADLER (LICSW) – Clinical Social Worker, NPI 1073514196

Clinical Social Worker

BRONSON DESTADLER (LICSW) is a healthcare provider. based in Newburyport, Massachusetts. specializing in Clinical Social Worker. They hold the professional credentials LICSW. They hold a License No. 106400 (MA). The NPI Number for BRONSON DESTADLER (LICSW) is 1073514196

Main info

Male

44 Years Of Experience

Accepts Medicare Assignment

Name

BRONSON DESTADLER (LICSW)

NPI

1073514196

Phone

(978) 462-2890

Address

143 STATE ST

Enumeration Date

10 August 2005

Last Update Date

8 July 2007

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9784621602

Graduation Year

1982 (44 years ago)

PAC ID

2668442377

Professional Enrollment ID

I20040729000975

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience54

Completeness75

Years active:20State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for BRONSON DESTADLER (LICSW)

143, State Street, Subdistrict C, Newburyport, Essex County, Massachusetts, 01922, United States
NEWBURYPORT, MA 019506621
Phone: (978) 462-2890
Fax: (978) 462-2890
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01950)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Is BRONSON DESTADLER (LICSW) listed with a National Provider Identifier?

Yes — BRONSON DESTADLER (LICSW) has NPI 1073514196 on file in the registry.

Is BRONSON DESTADLER (LICSW) still an active registrant?

BRONSON DESTADLER (LICSW) carries an active NPI according to the public dataset.

What clinical focus is listed for BRONSON DESTADLER (LICSW)?

At a glance, BRONSON DESTADLER (LICSW) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.

Is BRONSON DESTADLER (LICSW) located near Newburyport?

BRONSON DESTADLER (LICSW) currently maps to Newburyport, Massachusetts in this extract.

Can I trust this NPI listing for BRONSON DESTADLER (LICSW)?

The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.