Individual provider Active NPI

Kimberly Marie Widicker-Densberger, LCSW, LMHP

  • Clinical Social Worker
  • Lincoln, NE
National Provider Identifier
1033418355
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8081 Issued in NE
Practice address
1005 O Street
Suite 300
Lincoln, NE 68508
Phone
(402) 441-8817
Fax
(402) 441-7160
NPI assigned
Mar 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8081 NE Primary

Addresses

Primary practice location

1005 O Street
Suite 300
Lincoln, NE 68508

Mailing address

5849 Randolph St
Lincoln, NE 68510-3949
Phone (402) 441-8817

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1033418355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 RANDOLPH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103949",
            "telephone_number": "402-441-8817",
            "fax_number": "402-441-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 O STREET",
            "address_2": "SUITE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68508",
            "telephone_number": "402-441-8817",
            "fax_number": "402-441-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDICKER-DENSBERGER",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "8081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.