Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Bronwen B. Ballou, LICSW

Individual provider Clinical Social Worker · NPI 1558485490

MS. Bronwen B. Ballou, LICSW is a Clinical Social Worker in Lebanon, New Hampshire. Qualified in 1985, 41 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in New Hampshire.

Years since qualifying
41
Licensed in
NH
In the registry since
2007
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

367 State Route 120 Ste B1
Lebanon, NH 03766-1430
Phone: (603) 653-0199
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 949 (NH)

Record details

NPI number1558485490
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedMarch 17, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1985 (41 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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