Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

BRONSON DESTADLER LICSW
NPI 1073514196
Social Worker - Clinical in Newburyport, MA

Active since August 10, 2005
143 STATE ST, NEWBURYPORT, MA 01950(978) 462-2890(978) 462-2890 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Bronson Destadler Licsw NPPES

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

BRONSON DESTADLER LICSW (NPI 1073514196) is an individual clinical provider in Newburyport, Massachusetts, licensed in Massachusetts (106400) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1073514196
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameBRONSON DESTADLERCredential: LICSW
Location Address143 STATE STNewburyport, MA 01950-6621
Mailing Address143 State StNewburyport, MA 01950-6621 · (978) 462-2890 · Fax (978) 462-2890
Fax(978) 462-2890
Sole ProprietorNo
Enumeration DateAugust 10, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1073514196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MA · 106400
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

143 STATE ST, Newburyport, MA 01950

Other Providers at the Same Location


The following 15 providers are registered at the same or a nearby location.

Psychiatry & Neurology (Psychiatry)
143 STATE ST
NEWBURYPORT, MA 01950
Dentist (General Practice)
143 STATE ST, UNIT 1
NEWBURYPORT, MA 01950
Marriage & Family Therapist
143 STATE ST
NEWBURYPORT, MA 01950
Counselor (Mental Health)
143 STATE ST
NEWBURYPORT, MA 01950
Dentist
143 STATE ST
NEWBURYPORT, MA 01950
Counselor (Mental Health)
143 STATE ST
NEWBURYPORT, MA 01950
Dentist
143 STATE ST, UNIT 1
NEWBURYPORT, MA 01950
Counselor (Mental Health)
143 STATE ST
NEWBURYPORT, MA 01950
Social Worker (Clinical)
143 STATE ST
NEWBURYPORT, MA 01950
Registered Nurse (Psychiatric/Mental Health)
143 STATE ST
NEWBURYPORT, MA 01950
Social Worker (Clinical)
143 STATE ST
NEWBURYPORT, MA 01950
Social Worker (Clinical)
143 STATE ST
NEWBURYPORT, MA 01950
Counselor (Addiction (Substance Use Disorder))
143 STATE ST
NEWBURYPORT, MA 01950
Social Worker (Clinical)
143 STATE ST
NEWBURYPORT, MA 01950
Social Worker (Clinical)
143 STATE ST
NEWBURYPORT, MA 01950

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073514196, enumerated as an "individual" on August 10, 2005.

The provider is located at 143 STATE ST NEWBURYPORT, MA 01950 and the phone number is (978) 462-2890.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.