Bruce Balto, LISW, DCSW – Clinical Social Worker

Key facts

NPI: 1992866842
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: I-06300 (NM)
Practice address: 3417 Carlisle Blvd. NE
Albuquerque, NM 87110-1648
Phone: (505) 227-3052
Fax: (505) 792-4057
NPI assigned: Dec 13, 2006
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Heaven Sent LLC Assisted Living Facility · Albuquerque, NM · NPI 1841527108

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
I-06300	NM	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Heaven Sent LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	I-06300	NM	Yes

Addresses

Primary practice location

3417 Carlisle Blvd. NE
Albuquerque, NM 87110-1648

Mailing address

PO Box 67691
Albuquerque, NM 87193-7691
Phone (505) 227-3052

Other identifiers

Identifier	Type	State	Issuer
17502331	Medicaid	NM

Other providers in Albuquerque, NM

All providers in Albuquerque, NM · Clinical Social Worker in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.