MRS. BRANDYLYN S BRISTOW (LCSW) – Clinical Social Worker, NPI 1154630770

MRS. BRANDYLYN S BRISTOW (LCSW) is a healthcare provider. based in Hermann, Missouri. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 20080000932 (MO). The NPI Number for MRS. BRANDYLYN S BRISTOW (LCSW) is 1154630770

Main info

Female
Sole Proprietor
21 Years Of Experience
Accepts Medicare Assignment
Name
MRS. BRANDYLYN S BRISTOW (LCSW)
NPI
1154630770
Phone
(573) 943-9973
Address
2591 FOWLER ROAD
Enumeration Date
30 September 2010
Last Update Date
20 February 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2005 (21 years ago)
PAC ID
6608216262
Group Practice PAC ID
5496669962
Professional Enrollment ID
I20240430000528
Address ID
MO650411547HE509XXBOXX601
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

1,245 CLINICAL SOCIAL WORKER in MO

Provider Addresses for MRS. BRANDYLYN S BRISTOW (LCSW)

  • 2591 FOWLER ROAD

    HERMANN, MO 65041

    Phone: (573) 943-9973

    Type: Mailing

  • 708 EAST HIGHWAY 28

    OWENSVILLE, MO 65066

    Phone: (573) 486-1193

    Fax: (573) 486-0910

    Type: Location

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: 2024-04-30

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
I20240430000528IClinical Social WorkerMOTBD

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 65041)

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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: 5496669962View full group profile
NameSpecialtyState
Hospitalist, Family PracticeMO
Hospitalist, Internal MedicineWI
-MO
H O S P I T A L I S TMO
Mental Health CounselorMO
Nurse PractitionerMO
Clinical Social WorkerMO
General SurgeryMO
Family PracticeMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

What NPI should I save for MRS. BRANDYLYN S BRISTOW (LCSW)?
Save NPI 1154630770 if you need a stable reference for MRS. BRANDYLYN S BRISTOW (LCSW).
Is MRS. BRANDYLYN S BRISTOW (LCSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MRS. BRANDYLYN S BRISTOW (LCSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for MRS. BRANDYLYN S BRISTOW (LCSW). Clinical services aligned with this taxonomy classification.
Does MRS. BRANDYLYN S BRISTOW (LCSW) practice in Missouri?
You will see Hermann, Missouri on file for MRS. BRANDYLYN S BRISTOW (LCSW) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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