Kelly Ryan Bronk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005096 Issued in CT

Practice address

36 Ice Pond LN
East Berlin, CT 06023-1020

Phone

(203) 507-8757

NPI assigned

May 5, 2025

Last updated

May 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, CT

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1992594196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 ICE POND LN",
            "city": "EAST BERLIN",
            "state": "CT",
            "postal_code": "060231020",
            "telephone_number": "203-507-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 ICE POND LN",
            "city": "EAST BERLIN",
            "state": "CT",
            "postal_code": "060231020",
            "telephone_number": "203-507-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONK",
        "first_name": "KELLY",
        "middle_name": "RYAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Afi Healing Hands International LLC
• Monica Alexandra Ayora-Castro
• Balance Therapy Services, LLC
• Christina Marie Biondo
• Irene Bosco
• Emily Bryant
• Joseph Cannata, RPH
• Chartwell Southern New England, LLC (Option Care)
• Kendell Lamonte Coker, PH.D., J.D.
• Concierge by NRC

• Clinical Social Worker in East Berlin, CT
• Providers in East Berlin, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.