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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. BONITA RAE WICKSTROM LISW
NPI 1225075161
Social Worker in Albuquerque, NM

Active since May 31, 2006PECOS Enrolled
12836 LOMAS BLVD NE, SUITE B, ALBUQUERQUE, NM 87112(505) 453-7862 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Bonita Rae Wickstrom Lisw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. BONITA RAE WICKSTROM LISW (NPI 1225075161) is an individual social worker in Albuquerque, New Mexico, licensed in New Mexico (I-4390) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225075161
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameMS. BONITA RAE WICKSTROMCredential: LISW
Location Address12836 LOMAS BLVD NE, SUITE BAlbuquerque, NM 87112-6210
Mailing Address14507 Encantado Rd NeAlbuquerque, NM 87123-2249 · (505) 275-7795
Phone(505) 453-7862
Sole ProprietorNo
Enumeration DateMay 31, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1225075161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in NM · I-4390
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
12836 LOMAS BLVD NE, Albuquerque, NM 87112
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Bonita Rae Wickstrom Lisw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. ELLEN M. CURLEY-ROAM LISW
Social Worker (Clinical)
12836 LOMAS BLVD NE, SUITE B
ALBUQUERQUE, NM 87112
Bernalillo County (505) 306-6047
MS. LUCY A BIRBIGLIA LCSW LISW
Social Worker (Clinical)
12836 LOMAS BLVD NE, SUITE B
ALBUQUERQUE, NM 87112
Bernalillo County (505) 307-3718
BONITA WICKSTROM INC
Social Worker (Clinical)
12836 LOMAS BLVD NE, SUITE B
ALBUQUERQUE, NM 87112
Bernalillo County (505) 453-7862
DR. BHALACHANDRA A KULKARNI MD
Family Medicine
12836 LOMAS BLVD NE, SUITE D
ALBUQUERQUE, NM 87112
Bernalillo County (505) 298-0230
MS. LYNETTE A CURLEY-ROAM LISW, REV.
Social Worker (Clinical)
12836 LOMAS BLVD NE, STE. B
ALBUQUERQUE, NM 87112
Bernalillo County (505) 306-6272

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bonita Wickstrom's NPI number?

The NPI number for Bonita Wickstrom is 1225075161. It was assigned to this individual provider in the NPPES registry on May 31, 2006.

Where is Bonita Wickstrom located?

Bonita Wickstrom practices at 12836 Lomas Blvd NE Suite B, Albuquerque, NM 87112. The listed phone number is (505) 453-7862.

What is Bonita Wickstrom's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Bonita Wickstrom enrolled in Medicare?

Yes. Bonita Wickstrom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bonita Wickstrom was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.