DR. MICHAEL A DESTEFANO PH.D.
NPI 1982972378
Psychologist in Bryn Mawr, PA

Active since December 13, 2011Opted out of Medicare · through Apr 1, 2027
14 S BRYN MAWR AVE, SUITE 205, BRYN MAWR, PA 19010(610) 525-4828 Get Directions Write a Review

NPPES record last updated: December 13, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Michael A Destefano Ph.d. NPPES

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

DR. MICHAEL A DESTEFANO PH.D. (NPI 1982972378) is an individual psychologist in Bryn Mawr, Pennsylvania, licensed in Pennsylvania (PS004910L) and active in the NPI registry since December 2011. He has opted out of Medicare through April 1, 2027.

NPPES Registry Identity

NPI1982972378
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. MICHAEL A DESTEFANOCredential: PH.D.
Location Address14 S BRYN MAWR AVE, SUITE 205Bryn Mawr, PA 19010-3216
Mailing Address119 Kenilworth RdMerion Station, PA 19066-1309 · (610) 246-2534
Sole ProprietorNo
Enumeration DateDecember 13, 2011
NPI 1982972378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in PA · PS004910L
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PS004910L (PA)
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License PS004910L (PA)
14 S BRYN MAWR AVE, Bryn Mawr, PA 19010

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Michael A Destefano Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2021 through April 1, 2027.

Opt-Out Effective DateApril 1, 2021
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
14 S BRYN MAWR AVE, SUITE 100
BRYN MAWR, PA 19010
Acupuncturist
14 S BRYN MAWR AVE, SUITE 101
BRYN MAWR, PA 19010
Psychologist (Clinical)
14 S BRYN MAWR AVE, SUITE 205
BRYN MAWR, PA 19010
Dentist (Periodontics)
14 S BRYN MAWR AVE
BRYN MAWR, PA 19010
Psychologist (Clinical)
14 S BRYN MAWR AVE, SUITE 205
BRYN MAWR, PA 19010
Psychologist
14 S BRYN MAWR AVE
BRYN MAWR, PA 19010
Psychologist
14 S BRYN MAWR AVE, SUITE 205
BRYN MAWR, PA 19010
Dentist (General Practice)
14 S BRYN MAWR AVE, SUITE #200
BRYN MAWR, PA 19010

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Destefano's NPI number?

The NPI number for Michael Destefano is 1982972378. It was assigned to this individual provider in the NPPES registry on December 13, 2011.

Where is Michael Destefano located?

Michael Destefano practices at 14 S Bryn Mawr Ave Suite 205, Bryn Mawr, PA 19010. The listed phone number is (610) 525-4828.

What is Michael Destefano's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Michael Destefano enrolled in Medicare?

No. Michael Destefano has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Michael Destefano was last updated on December 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.