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MARY KELLEEN BERMENSOLO LCSW
NPI 1659420693
Social Worker - Clinical in Boise, ID

Active since January 09, 2007PECOS EnrolledAccepts Medicare Assignment
410 S ORCHARD ST, STE 132, BOISE, ID 83705(208) 412-6683(208) 888-2215 Get Directions Write a Review

NPPES record last updated: January 16, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mary Kelleen Bermensolo Lcsw NPPES

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

MARY KELLEEN BERMENSOLO LCSW (NPI 1659420693) is an individual clinical provider in Boise, Idaho, licensed in Idaho (LCSW492) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1984).

NPPES Registry Identity

NPI1659420693
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMARY KELLEEN BERMENSOLOCredential: LCSW
Location Address410 S ORCHARD ST, STE 132Boise, ID 83705-1288
Mailing Address410 S Orchard St, Ste 132Boise, ID 83705-1288 · (208) 412-6683 · Fax (208) 888-2215
Phone(208) 412-6683
Fax(208) 888-2215
Sole ProprietorYes
Medical School CMSOtherGraduated 1984
Enumeration DateJanuary 9, 2007
Last NPPES UpdateJanuary 16, 2019
✔ NPI 1659420693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in ID · LCSW492
Definition
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
410 S ORCHARD ST, Boise, ID 83705
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Select Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary Kelleen Bermensolo Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658462254
PECOS Enrollment IDI20070810000812
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
256 services29 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83705 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $52.44 – $160.17
Typical copayment $0.00 (range $13.11 – $40.04)
Most-billed visit code NA
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

MS. PATRICIA MARIE ALEXANDER LCPC
Counselor (Professional)
410 S ORCHARD ST, SUITE 132
BOISE, ID 83705
Ada County (208) 724-2448
HEATHER LEIGH DONAHUE LCSW
Counselor (Mental Health)
410 S ORCHARD ST
BOISE, ID 83705
Ada County (208) 323-0996
MRS. TIFFANY MYERS M.S.
Counselor
410 S ORCHARD ST, 184
BOISE, ID 83705
Ada County (208) 922-6714
LUTHERAN COMMUNITY SERVICES NW
Counselor (Mental Health)
410 S ORCHARD ST, SUITE 124
BOISE, ID 83705
Ada County (208) 323-0996
MARISSA NICKEL LCSW
Social Worker (Clinical)
410 S ORCHARD ST, STE. 232
BOISE, ID 83705
Ada County (208) 371-5733
CAMRYN KAARLSEN
Counselor
410 S ORCHARD ST
BOISE, ID 83705
Ada County (208) 214-7408
MRS. MELISSA JIMENEZ CHALOM LPC, NCC
Counselor (Professional)
410 S ORCHARD ST, SUITE 184
BOISE, ID 83705
Ada County (208) 409-3799
MR. JOSEPH SEIDERS LCSW
Social Worker (Clinical)
410 S ORCHARD ST, SUITE 124A
BOISE, ID 83705
Ada County (208) 391-3849

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 Mary Bermensolo's NPI number?

The NPI number for Mary Bermensolo is 1659420693. It was assigned to this individual provider in the NPPES registry on January 9, 2007.

Where is Mary Bermensolo located?

Mary Bermensolo practices at 410 S Orchard St Ste 132, Boise, ID 83705. The listed phone number is (208) 412-6683.

What is Mary Bermensolo's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Mary Bermensolo enrolled in Medicare?

Yes. Mary Bermensolo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mary Bermensolo accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans and Select Health list Mary Bermensolo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Bermensolo was last updated on January 16, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.