BONNIE LYNN BALSAMO (LICSW) – Clinical Social Worker, NPI 1164776431

BONNIE LYNN BALSAMO (LICSW) is a healthcare provider. based in Johnstown, Colorado. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 089.0127277 (VT). The NPI Number for BONNIE LYNN BALSAMO (LICSW) is 1164776431

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
BONNIE LYNN BALSAMO (LICSW)
NPI
1164776431
Phone
(603) 548-5208
Address
377 MAESTES ST
Enumeration Date
7 November 2012
Last Update Date
15 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6036361101
Graduation Year
2006 (20 years ago)
PAC ID
5799069993
Group Practice PAC ID
2769461284
Professional Enrollment ID
I20170413002253
Address ID
NH035824061GR47XXXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience77
Completeness75
Years active:13State licenses:4Digital endpointsOther names

536 CLINICAL SOCIAL WORKER in NH

Provider Addresses for BONNIE LYNN BALSAMO (LICSW)

  • 377 MAESTES ST

    JOHNSTOWN, CO 805349011

    Phone: (603) 548-5208

    Type: Mailing

  • 47 Church St

    Groveton, NH 035824061

    Phone: (603) 788-5075

    Fax: (603) 788-5285

    Type: Location

  • 173 Middle St

    Lancaster, NH 035843508

    Phone: (603) 788-5075

    Fax: (603) 788-5285

    Type: Location

  • 141 CORLISS LN

    COLEBROOK, NH 035763206

    Phone: (603) 788-5075

    Fax: (037) 885-2856

    Type: Location

  • 173 MIDDLE ST

    LANCASTER, NH 035843508

    Phone: (603) 788-5029

    Fax: (603) 788-5607

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-04-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170413002253IClinical Social WorkerNHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 80534)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769461284View full group profile
NameSpecialtyState
-NH
Nurse PractitionerNH
Nurse PractitionerNH
P O D I A T R YNH
-NH
Physician AssistantNH
-WY
Family Practice, HospitalistNH
Internal MedicineMD
Nurse PractitionerNH

Reviews

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Frequently asked questions

Does BONNIE LYNN BALSAMO (LICSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BONNIE LYNN BALSAMO (LICSW) uses 1164776431.
Is BONNIE LYNN BALSAMO (LICSW) still practicing?
BONNIE LYNN BALSAMO (LICSW) is currently listed as active in the public NPI registry.
What healthcare role does BONNIE LYNN BALSAMO (LICSW) hold?
Scheduling teams often label BONNIE LYNN BALSAMO (LICSW) under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is BONNIE LYNN BALSAMO (LICSW) based?
BONNIE LYNN BALSAMO (LICSW) is tied to Johnstown, Colorado in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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