Bronson Destadler, LICSW in Newburyport, MA - Medicare Social Worker Provider

Bronson Destadler, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Newburyport, Massachusetts. His current practice location is 143 State St, Newburyport, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (978) 462-2890.

Bronson Destadler is licensed to practice in Massachusetts (license number 106400) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1073514196.

Contact Information

	Bronson Destadler, LICSW
	143 State St, Newburyport, MA 01950-6621
	(978) 462-2890
	(978) 462-2890

Map and Direction

Healthcare Provider's Profile

Full Name	Bronson Destadler
Gender	Male
Speciality	Social Worker - Clinical
Location	143 State St, Newburyport, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073514196
Provider Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 2668442377
Enrollment ID: I20040729000975

Medical Identifiers

Medical identifiers for Bronson Destadler such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073514196	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	106400 (Massachusetts)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bronson Destadler is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Bronson Destadler, LICSW 143 State St, Newburyport, MA 01950-6621 Ph: (978) 462-2890	Bronson Destadler, LICSW 143 State St, Newburyport, MA 01950-6621 Ph: (978) 462-2890

Reviews and Comments

Social Worker in Newburyport, MA

Melinda Grey Crossman, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 28 Green St, The Carriage House, Newburyport, MA 01950 Phone: 978-270-3736
Richard J Healy, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 143 State St, Newburyport, MA 01950 Phone: 978-462-2890 Fax: 978-462-2890
Susan M Vanetten, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 23 Green St, Newburyport, MA 01950 Phone: 978-891-0264
Mr. Bruce Edward Deveau, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 42 Pleasant St, Suite 7, Newburyport, MA 01950 Phone: 978-462-3287 Fax: 978-462-3287
Liza P Brackbill, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 255 Low St Ste 302, Newburyport, MA 01950 Phone: 978-222-3121
Barbara Allen Keeler, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1 Merrimac St, Suite 17, Newburyport, MA 01950 Phone: 978-465-6585 Fax: 978-465-9498

Bronson Destadler, LICSW - Medicare Clinical Social Worker in Newburyport, MA