Individual provider · Type 1 NPI
Mary Kelleen Bermensolo, LCSW
Clinical Social Worker · Boise, ID
Practice location
410 S Orchard St Ste 164
Boise, ID 83705-1295
Fax (208) 279-0481
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | LCSW492 (ID) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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- Amy Niblock Balzer, LCSWClinical Social Worker Boise, ID NPI 1013379536
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About NPI 1659420693
Mary Kelleen Bermensolo, LCSW's National Provider Identifier is 1659420693, issued on Jan 9, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Boise, ID. The record was last updated on Sep 23, 2026.