Carrie Lynn Thompson Widmer, LCSW
Individual provider Active NPI Mental Health Counselor · Turtle Lake, ND
NPI 1124450556 · NPPES record last updated Aug 10, 2023
Key facts
- NPI
- 1124450556
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 4938 (ND)
- Practice address
- 416 Kundert St
Turtle Lake, ND 58575-4205 - Phone
- (701) 448-9225
- Fax
- (701) 448-2056
- NPI assigned
- Aug 8, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230710002384 | ND | Practitioner - Clinical Social Worker | 5890154728 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northland Health Centers | Current | Accepting new patients | |
| Northland Health Centers | Current |
Accepting new patients | |
| Northland Health Centers | Current |
Accepting new patients |
Locations
122 2nd St E
McClusky, ND 58463
Phone (701) 363-2296
416 Kundert St
Turtle Lake, ND 58575
Phone (701) 448-2331
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4938 | ND | Yes |
| Social Worker | 104100000X |
Addresses
Primary practice location
416 Kundert St
Turtle Lake, ND 58575-4205
Mailing address
416 Kundert St
Turtle Lake, ND 58575-4205
Phone (701) 448-9225
Other providers in Turtle Lake, ND
- St. Alexius Medical Center
- St. Alexius Medical Center
- St. Alexius Medical Center
- St. Alexius Medical Center
- Kimberly K Sundquist
- Amanda Troyna
- Turtle Lake Ambulance Service, Inc
- Turtle Lake Rexall Drug Inc.
- Turtle Lake Rural Ambulance District
- Susan Wardner
All providers in Turtle Lake, ND · Mental Health Counselor in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.